CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Dupont Hospital LLC

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $848
  • Cash Discount Price: $806
  • vs. Medicare Baseline: 3.48x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Dupont Hospital LLC is $848. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $806. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.48x the Medicare baseline. Located in 2520 E Dupont Rd, Fort Wayne, IN.
Cash / Self-Pay
$806

Average discount available for prompt cash payment at this facility.

Insurance Median
$848

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: $806 (331%)
Insurance Median: $848 (348%)
Cash: $806 (331% of Medicare)
Ins. Median: $848 (348% 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 348% of the Medicare baseline (a markup of 248%). 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
Veterans Eval Services $222 91%
UnitedHealthcare $224 - $2,021 92%
Tricare $240 98%
Aetna $248 - $1,255 102%
Blue Cross Blue Shield $248 - $1,037 102%
Humana $248 - $458 102%
Medicare (plans) $248 102%
Node Mhs Mcr Adv $248 102%
Department Of Veterans Affairs $252 103%
Iu Health $252 103%
Node Non Par Hospice Agree $252 103%
Node Va $252 103%
Node Devoted Health Mcr Adv $253 104%
In Dept Of Correction $263 108%
Node Pphp Mcr Adv $265 109%
Us Department Of Labor $316 130%
Lutheran Advanced Network $379 155%
Lutheran Preferred $379 - $1,684 155%
Lutheran Preferred Fixed 2 $379 155%
Managed Health Services $379 - $505 155%
Align In Work Comp $404 166%
Encore Work Comp In $454 186%
Prime Health Services $454 - $2,105 186%
Caresource $458 188%
Medicaid / KanCare $458 188%
In Work Comp $505 207%
Amish Aid $512 - $758 210%
Self Pay $512 - $1,263 210%
Php Freedom Network $591 242%
Encore Kba Epo $606 249%
Cigna $613 - $1,019 251%
Lutheran Network $690 283%
Physicians Health Plan $735 - $1,087 302%
Encore Kba Ppo $757 311%
Medical Mutual Of Oh $1,006 - $1,488 413%
Encore Ppo $1,260 517%
Sagamore $1,273 522%
Frontpath $1,518 - $2,246 623%
Encore Health Network $1,556 - $2,526 638%
Advantage Health Solutions $1,575 - $2,330 646%
Multiplan $1,632 - $2,526 669%
Allied Benefit Systems $1,708 - $2,526 701%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2520 E Dupont Rd, Fort Wayne, IN 46825
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals