CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Sparrow Ionia Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $569
Cash Discount Price: $319
vs. Medicare Baseline: 2.33x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Sparrow Ionia Hospital is $569. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $319. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.33x the Medicare baseline. Located in 3565 S State Road, Ionia, MI.

Cash / Self-Pay

$319

Average discount available for prompt cash payment at this facility.

Insurance Median

$569

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: $319 (131%)

Insurance Median: $569 (233%)

Cash: $319 (131% of Medicare)

Ins. Median: $569 (233% 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 233% of the Medicare baseline (a markup of 133%). 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
Medicaid / KanCare	$45 - $268	18%
Medicare (plans)	$66 - $604	27%
Blue Cross Blue Shield	$111 - $1,428	46%
Priority Health Medihmo	$244	100%
Aetna	$256 - $1,708	105%
Covenant Advantage	$569	233%
Medigold	$569	233%
Senior Community Care	$569	233%
Humana	$598 - $1,844	245%
Priority	$1,397	573%
UnitedHealthcare	$1,746	716%
Cigna	$1,803	740%
Great West Healthcare	$1,803	740%
Asr	$1,822	747%
Blue Care Network	$1,822	747%
Health Alliance Plan	$1,822	747%
Cofinity	$1,844	756%
Mclaren Commercial	$2,029	832%

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 $319.
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 Sparrow Ionia 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.