CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Ruby Valley Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $2,161
  • Cash Discount Price: $2,138
  • vs. Medicare Baseline: 8.86x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Ruby Valley Medical Center is $2,161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,138. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.86x the Medicare baseline. Located in 321 Madison St, Sheridan, MT.
Cash / Self-Pay
$2,138

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,161

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: $2,138 (877%)
Insurance Median: $2,161 (886%)
Cash: $2,138 (877% of Medicare)
Ins. Median: $2,161 (886% 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 886% of the Medicare baseline (a markup of 786%). 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
Medicare (plans) $146 - $1,662 60%
Aetna $188 - $2,256 77%
Medicaid / KanCare $192 - $2,185 79%
Monida $199 - $2,304 82%
Blue Cross Blue Shield $2,138 - $2,375 877%
Cigna $2,138 - $2,256 877%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 321 Madison St, Sheridan, MT 59749
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals