CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Holmes County Hospital and Clinics

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $816
  • Cash Discount Price: $631
  • vs. Medicare Baseline: 3.35x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Holmes County Hospital and Clinics is $816. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $631. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.35x the Medicare baseline. Located in 239 Bowling Green Road, Lexington, MS.
Cash / Self-Pay
$631

Average discount available for prompt cash payment at this facility.

Insurance Median
$816

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: $631 (259%)
Insurance Median: $816 (335%)
Cash: $631 (259% of Medicare)
Ins. Median: $816 (335% 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 335% of the Medicare baseline (a markup of 235%). 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
Ms-Can-Molina-Lex $190 78%
Ms-Can-Magnolia-Lex $192 79%
Ms-Can-Truecare-Lex $193 79%
Molina-Chip-Lex $405 166%
Magnolia-Chip-Lex $414 170%
Truecare-Chip-Lex $414 170%
Advhealth-Lex $486 199%
Tricare $527 - $1,408 216%
Humana $536 - $1,432 220%
Mpcn-Lex $558 - $1,492 229%
Medadv_Uhc-Lex $584 - $1,560 240%
Firstchoice-Lex $601 - $1,606 247%
Ambetter / Centene $644 - $1,721 264%
Medadv_Primewell-Lex $644 - $1,721 264%
Medicare (plans) $644 - $1,721 264%
Primewell-Lex $644 - $1,721 264%
Va_Ccn-Lex $644 - $1,721 264%
Medadv_Uhcdsnp-Lex $664 - $1,773 272%
Wellcare-Lex $664 - $1,773 272%
Ppoplus $670 - $1,790 275%
Devoted_Health-Lex $676 - $1,807 277%
Firsthealth-Lex $687 - $1,836 282%
Multiplan-Lex $687 - $1,836 282%
Blue Cross Blue Shield $711 292%
Aetna $730 - $1,951 299%
Phcs-Lex $773 - $2,066 317%
Cigna $859 - $1,822 352%
Molina_Exchange-Lex $859 - $2,295 352%
United-Lex $859 - $1,390 352%
United-Options-Lex $859 - $1,875 352%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 239 Bowling Green Road, Lexington, MS 39095
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - State
  • Hospital Type: Critical Access Hospitals