CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Sanford Worthington Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,807
Cash Discount Price: $3,169
vs. Medicare Baseline: 7.41x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Sanford Worthington Medical Center is $1,807. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,169. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.41x the Medicare baseline. Located in 1018 Sixth Avenue Po Box 997, Worthington, MN.

Cash / Self-Pay

$3,169

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,807

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: $3,169 (1300%)

Insurance Median: $1,807 (741%)

Cash: $3,169 (1300% of Medicare)

Ins. Median: $1,807 (741% 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 741% of the Medicare baseline (a markup of 641%). 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	$181 - $1,782	74%
Sanford Health Plan Align	$225	92%
Ucare	$242 - $3,094	99%
Aetna	$244 - $3,248	100%
Health Partners	$244 - $2,812	100%
Medicare (plans)	$244	100%
UnitedHealthcare	$244 - $3,307	100%
Primewest	$249 - $266	102%
Sanford Health Plan	$1,536 - $1,807	630%
Security Health Plan	$2,179	894%
Medica	$3,533 - $3,783	1449%
First Choice Health Network	$3,565	1462%
Healthez	$3,565	1462%
Multiplan	$3,565	1462%

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 $3,169.
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 Sanford Worthington Medical Center 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.