CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Boston Children's Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,966
Cash Discount Price: $2,769
vs. Medicare Baseline: 8.06x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Boston Children's Hospital is $1,966. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,769. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.06x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$2,769

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,966

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: $2,769 (1136%)

Insurance Median: $1,966 (806%)

Cash: $2,769 (1136% of Medicare)

Ins. Median: $1,966 (806% 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 806% of the Medicare baseline (a markup of 706%). 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
Unicare	$1,160	476%
Cdphp	$1,357 - $2,354	557%
Blue Cross Blue Shield	$1,378 - $1,828	565%
Harvard Pilgrim	$1,407 - $1,871	577%
United	$1,656 - $2,314	679%
Aetna	$1,661 - $2,321	681%
Mgb/Allways	$1,684 - $2,047	691%
Tufts Public Plan	$1,701 - $1,705	698%
United Ri Nj Ny	$1,744	715%
Ambetter / Centene	$1,750	718%
Carelon Strategies/Bhs	$1,800	738%
UnitedHealthcare	$1,800 - $2,354	738%
Carelon/Beacon	$2,077	852%
Fallon	$2,113 - $2,135	867%
Health New England	$2,237	918%
Cigna	$2,354 - $2,499	966%
Ets/Lifetrac	$2,354	966%
Interlink Transplant	$2,354	966%
Community Health Options	$2,492	1022%
Humana	$2,492	1022%
Coventry/Hcvm/First Health	$2,547	1045%
Multiplan/Phcs	$2,547 - $2,631	1045%

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 $2,769.
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 Boston Children's 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.