CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Promedica Monroe Regional Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $371
Cash Discount Price: $1,882
vs. Medicare Baseline: 1.52x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Promedica Monroe Regional Hospital is $371. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,882. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.52x the Medicare baseline. Located in 718 N Macomb St, Monroe, MI.

Cash / Self-Pay

$1,882

Average discount available for prompt cash payment at this facility.

Insurance Median

$371

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: $1,882 (772%)

Insurance Median: $371 (152%)

Cash: $1,882 (772% of Medicare)

Ins. Median: $371 (152% 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
Meridian	$131	54%
Priority Health	$131 - $1,593	54%
Blue Cross Blue Shield	$137 - $1,627	56%
Aetna	$141 - $2,039	58%
Molina Healthcare Of Michigan	$141	58%
UnitedHealthcare	$144 - $2,352	59%
Paramount Healthcare Inc	$173 - $2,201	71%
Amerihealth	$177	73%
Health Alliance Plan	$177 - $2,375	73%
Humana	$182 - $244	75%
Veterans Affairs	$240	98%
Frontpath	$1,680	689%
Encore Health Network	$2,027	832%
Health Ohio Network, Llc	$2,027	832%
Cofinity	$2,065	847%
Multiplan	$2,606	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 $1,882.
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 Promedica Monroe Regional 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.