CMS Price Transparency Data
MRI, lower back (no contrast)
Facility: Saint Joseph Regional Medical Center - Plymouth
Billing Code: 72148 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72148
- Insurance Median: $2,863
- Cash Discount Price: $3,026
- vs. Medicare Baseline: 11.74x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Saint Joseph Regional Medical Center - Plymouth is $2,863. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,026. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.74x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$3,026
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,863
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$243.77
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $3,026 (1241%)
Insurance Median: $2,863 (1174%)
Cash: $3,026 (1241% of Medicare)
Ins. Median: $2,863 (1174% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $243.77 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 1174% of the Medicare baseline (a markup of 1074%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Input your details and click calculate to compare out-of-pocket costs.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $131 - $3,026 | 54% |
| Blue Cross Blue Shield | $131 - $891 | 54% |
| Medicaid / KanCare | $131 - $458 | 54% |
| UnitedHealthcare | $131 - $1,056 | 54% |
| Medicare (plans) | $252 - $257 | 103% |
| Meridian Complete | $252 | 103% |
| Pace-Trinity Health | $252 | 103% |
| County Coroner | $263 | 108% |
| Provider Partners Health Plan Of Indiana | $278 | 114% |
| Auxiant | $379 - $3,864 | 155% |
| Physicians Health Plan Northern Indiana Health Insurance | $379 - $762 | 155% |
| St Joseph County Hlth Dpt | $379 | 155% |
| Caresource | $391 | 160% |
| Siho Insurance Services | $404 | 166% |
| Key Benefit Administrator | $454 - $3,264 | 186% |
| Managed Health Services - Indiana | $458 | 188% |
| Mdwise | $458 | 188% |
| Allied Benefit Systems | $480 - $3,026 | 197% |
| Custom Design Benefits | $543 | 223% |
| Blue Benefit Administrators Of Massachusetts | $891 | 366% |
| Blue Care Network | $891 | 366% |
| Blue Distinction Transplant | $891 | 366% |
| Blue Shield - Ca | $891 | 366% |
| Blue Shield - Id (Regence) | $891 | 366% |
| Blue Shield - Ny Highmark Northeastern | $891 | 366% |
| Blue Shield - Ny Highmark Western | $891 | 366% |
| Blue Shield - Pa (Highmark) | $891 | 366% |
| Blue Shield - Wa (Regence) | $891 | 366% |
| Geha | $1,056 | 433% |
| Healthscope | $1,056 | 433% |
| Student Insurance Cma | $1,056 | 433% |
| Plain Church Group | $1,257 | 516% |
| Notre Dame Athletic Association | $2,560 | 1050% |
| Wc Notre Dame | $2,560 | 1050% |
| Luminare Health (Detroit) | $2,653 - $2,793 | 1088% |
| Ameriben | $2,793 | 1146% |
| Asr Health Benefits | $3,026 | 1241% |
| Christian Brother Services | $3,026 | 1241% |
| Employee Benefit Management | $3,026 | 1241% |
| Medical Mutual | $3,026 | 1241% |
| Meritain | $3,026 | 1241% |
| Preferred One | $3,026 | 1241% |
| Rural Carrier Health Benefit Plan | $3,026 | 1241% |
| Webtpa | $3,026 | 1241% |
| Encore Health | $3,264 | 1339% |
| Indiana Criminal Justice Inst | $3,264 | 1339% |
| Western & Southern Financial Group | $3,264 | 1339% |
| Cigna | $3,352 | 1375% |
| Group Administrators | $3,352 | 1375% |
| Health Partners | $3,352 | 1375% |
| Mvp | $3,352 | 1375% |
| Prairie States | $3,352 | 1375% |
| Priority Health | $3,352 | 1375% |
| Professional Benefit Administrators | $3,352 | 1375% |
| Sagamore Health Network | $3,352 - $3,584 | 1375% |
| Sisco Benefits | $3,352 | 1375% |
| Unified Group Services | $3,352 | 1375% |
| Goshen Preferred Network | $3,584 - $4,003 | 1470% |
| Signature Care | $3,864 | 1585% |
| Allied National Global Care | $4,190 | 1719% |
| Asrm - Reliance Standard Life Insurance | $4,190 | 1719% |
| Avmed Health Plan | $4,190 | 1719% |
| Christian Care Ministry | $4,190 | 1719% |
| Dean Health | $4,190 | 1719% |
| Fallon Health | $4,190 | 1719% |
| Family Life Insurance Company | $4,190 | 1719% |
| Freedom Life Insurance Company | $4,190 | 1719% |
| Ghc Scw | $4,190 | 1719% |
| International Benefit Administrators | $4,190 | 1719% |
| Lifetime Benefit Solutions | $4,190 | 1719% |
| Manhattan Life | $4,190 | 1719% |
| Medi Share | $4,190 | 1719% |
| Multiplan | $4,190 | 1719% |
| Pai | $4,190 | 1719% |
| Pan-American Life | $4,190 | 1719% |
| Paramount Hmo | $4,190 | 1719% |
| Phcs | $4,190 | 1719% |
| Philadelphia American Life Insurance | $4,190 | 1719% |
| Trinity Health Share | $4,190 | 1719% |
| Bankers Life Casualty | $4,655 | 1910% |
| Bureau Of Disability | $4,655 | 1910% |
| Wc Align Network | $4,655 | 1910% |