CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Woodlawn Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $805
Cash Discount Price: $2,401
vs. Medicare Baseline: 3.30x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Woodlawn Hospital is $805. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,401. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.30x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$2,401

Average discount available for prompt cash payment at this facility.

Insurance Median

$805

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: $2,401 (985%)

Insurance Median: $805 (330%)

Cash: $2,401 (985% of Medicare)

Ins. Median: $805 (330% 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 330% of the Medicare baseline (a markup of 230%). 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
Blue Cross Blue Shield	$117 - $2,780	48%
Caresource Mcaid Hww	$117	48%
Mdwise Excel Hhw & Hcc	$117	48%
Mhs Mcaid Hcc	$117	48%
Mhs Mcaid Hhw	$117	48%
UnitedHealthcare	$117 - $2,780	48%
Aetna	$604 - $3,475	248%
Caresource Mcaid Hip	$604 - $805	248%
Caresource Mcr Adv	$604 - $805	248%
Humana	$604 - $2,839	248%
Mdwise Mcaid Excel Hip	$604 - $805	248%
Mhs Exch Mrktplce-All Other Plans	$604 - $805	248%
Mhs Mcaid Hip	$604 - $805	248%
Mhs Mcr Adv	$616 - $821	253%
Caresource Exch - All Other Plans	$785 - $1,046	322%
Ambetter / Centene	$803 - $1,070	329%
Partners Direct Health-All Plans	$1,866 - $2,487	765%
Cigna	$1,965 - $3,109	806%
Parkview Health Plans-All Plans	$2,058 - $2,744	844%
Sagamore All Other Grps - All Other Plans	$2,305 - $3,073	946%
Encore Comm-All Plans	$2,332 - $3,109	957%
Phcs/Multiplan-All Plans	$2,552 - $3,402	1047%
Community Health Alliance-All Plans	$2,607 - $3,475	1069%

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 $2,401.
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 Woodlawn 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.