CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Essentia Health Fosston

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,863
Cash Discount Price: $2,093
vs. Medicare Baseline: 7.64x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Essentia Health Fosston is $1,863. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,093. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.64x the Medicare baseline. Located in 900 Hilligoss Boulevard Se, Fosston, MN.

Cash / Self-Pay

$2,093

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,863

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: $2,093 (859%)

Insurance Median: $1,863 (764%)

Cash: $2,093 (859% of Medicare)

Ins. Median: $1,863 (764% 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 764% of the Medicare baseline (a markup of 664%). 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
Primewest	$236	97%
Itasca Med Care	$242	99%
Healthpartners Care Pmap	$1,102	452%
Medica Access	$1,127 - $1,764	462%
Sanford Health Plan	$1,215 - $1,279	498%
Advocare/Security Health	$1,416	581%
Blue Cross Blue Shield	$1,416 - $2,468	581%
Freedom Blue Ppo	$1,416	581%
Healthpartners Care Msho / Mcr Adv	$1,416	581%
Imcare Msho Pcc Prime	$1,416	581%
Imcare Msho Ref Req	$1,416	581%
Medica Advantage Solutions	$1,416	581%
Medica Msho/Dual Solutions	$1,416	581%
Medica Prime Solution Group	$1,416	581%
Medicare (plans)	$1,416	581%
Nd Va Administration	$1,416	581%
Platinum Blue/Vantage Blue	$1,416	581%
Primewest Msho	$1,416	581%
Secure Blue Msho	$1,416	581%
Ubh Cost Plan	$1,416	581%
Ubh Msho	$1,416	581%
Ucare Msho	$1,416	581%
UnitedHealthcare	$1,416 - $2,563	581%
Blue Plus Pmap Pcc Prime	$1,558 - $2,468	639%
Healthpartners	$1,722 - $1,883	706%
Ucare	$1,863	764%
Cigna	$1,883	772%
Healthpartners Pcc Prime	$1,883	772%
Wea	$2,039 - $2,181	836%
America'S Ppo	$2,195	900%
Wps	$2,351 - $2,379	964%
Medica	$2,353 - $2,478	965%
Medica Uplan	$2,353	965%
Aetna	$2,407	987%
Medica Choice	$2,552	1047%

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 $2,093.
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 Essentia Health Fosston 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.