CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Rush Memorial Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $800
Cash Discount Price: $1,151
vs. Medicare Baseline: 3.28x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Rush Memorial Hospital is $800. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,151. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.28x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$1,151

Average discount available for prompt cash payment at this facility.

Insurance Median

$800

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: $1,151 (472%)

Insurance Median: $800 (328%)

Cash: $1,151 (472% of Medicare)

Ins. Median: $800 (328% 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 328% of the Medicare baseline (a markup of 228%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$57 - $2,118	23%
Humana	$65 - $2,436	27%
Aetna	$66 - $2,436	27%
Caresource Mcr Adv	$66 - $821	27%
Blue Cross Blue Shield	$68 - $1,939	28%
Today'S Option Mcr Adv-All Plans	$68 - $845	28%
Viant Beech St Mcr Adv	$68 - $845	28%
My True Advantage - All Plans	$69 - $821	28%
Consumers Life Ins-All Plans	$72 - $2,383	30%
Caresource Marketplace-All Other Plans	$89 - $1,313	37%
Multiplan-All Plans	$91 - $2,462	37%
Encore Health Services-All Plans	$114 - $2,595	47%
Siho-All Plans	$114 - $2,436	47%
Phcs-All Plans	$160 - $2,118	66%
Cigna	$211 - $2,118	87%
Health Net	$211 - $780	87%
Coventry/First Health-All Plans	$295 - $2,383	121%
Sagamore-All Plans	$2,436	999%
Community Health Alliance-All Plans	$2,489	1021%

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 $1,151.
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 Rush Memorial Hospital 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.