CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Salem Memorial District Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $2,642
  • Cash Discount Price: $2,477
  • vs. Medicare Baseline: 10.84x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Salem Memorial District Hospital is $2,642. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,477. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.84x the Medicare baseline. Located in Po Box 774, Salem, MO.
Cash / Self-Pay
$2,477

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,642

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: $2,477 (1016%)
Insurance Median: $2,642 (1084%)
Cash: $2,477 (1016% of Medicare)
Ins. Median: $2,642 (1084% 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 1084% of the Medicare baseline (a markup of 984%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $1,123 - $2,972 461%
Ambetter / Centene $1,123 461%
Blue Cross Blue Shield $1,123 - $3,137 461%
Humana $1,123 - $2,807 461%
Tricare $1,123 461%
Triwest $1,123 461%
UnitedHealthcare $1,123 461%
Veteran'S Affairs $1,123 461%
Healthlink $2,146 880%
First Health $2,642 1084%
Mercy - C.B. Management Company/Joplin Supply Company $2,642 1084%
Mercy - City Of Springfield $2,642 1084%
Mercy - Clayco $2,642 1084%
Mercy - Commerce Bank $2,642 1084%
Mercy - Diversified Plastics $2,642 1084%
Mercy - Employers Benefit Alliance $2,642 1084%
Mercy - Evolutions $2,642 1084%
Mercy - Fabick Cat $2,642 1084%
Mercy - Firsthealth Network $2,642 1084%
Mercy - Health Management Network $2,642 1084%
Mercy - Health Systems Inc $2,642 1084%
Mercy - Liberty Utilities/Empire District Electric $2,642 1084%
Mercy - Life Church $2,642 1084%
Mercy - Missouri State University $2,642 1084%
Mercy - Prime Health Services $2,642 1084%
Mercy - Quiktrip Corporation $2,642 1084%
Mercy - Shinesolar $2,642 1084%
Mercy - Springfield Public Schools $2,642 1084%
Mercy - Springfield Remanufacturing $2,642 1084%
Mercy - Sumnerone $2,642 1084%
Mercy - Trailiner $2,642 1084%
Mercy - Walmart Mercy Accountable Care Plan $2,642 1084%
Mercy-American Healthcare Alliance $2,642 1084%
Phcs $2,642 - $2,807 1084%
Cigna $2,804 1150%
Mercy - Compresults $2,972 1219%
Mercy - Corvel Corporation $2,972 1219%
Mercy - Novasys $2,972 1219%
Mercy - Scurlock Industries $2,972 1219%
Mercy - Usa Managed Care Organization $2,972 1219%
Right Choice-Alliance $3,137 1287%
Right Choice-Regular $3,203 1314%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Po Box 774, Salem, MO 65560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals