CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Memorial Hospital and Health Care Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $115
Cash Discount Price: $573
vs. Medicare Baseline: 0.47x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Memorial Hospital and Health Care Center is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $573. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.47x the Medicare baseline. Located in 800 W 9Th St, Jasper, IN.

Cash / Self-Pay

$573

Average discount available for prompt cash payment at this facility.

Insurance Median

$115

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: $573 (235%)

Insurance Median: $115 (47%)

Cash: $573 (235% of Medicare)

Ins. Median: $115 (47% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$55 - $253	23%
Aetna	$65 - $253	27%
Caresource In Marketplace	$65 - $317	27%
Humana	$65 - $253	27%
Tricare	$65 - $215	27%
Mdwise	$66 - $117	27%
Mhs Hoosier Care Connect	$66 - $117	27%
Chamber Care	$67	27%
UnitedHealthcare	$73 - $760	30%
Immergrun	$78	32%
Ambetter / Centene	$85 - $329	35%
Onecare	$85	35%
Siho	$85	35%
Noncontracted	$104 - $405	43%
Patoka Valley	$112	46%
Encore	$114	47%
Encore Elite +	$114 - $608	47%
Cigna	$230	94%
Sagamore	$230	94%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $573.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72148.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Memorial Hospital and Health Care Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72148.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.