CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: North Carolina Baptist Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $945
Cash Discount Price: $1,390
vs. Medicare Baseline: 3.88x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at North Carolina Baptist Hospital is $945. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,390. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.88x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$1,390

Average discount available for prompt cash payment at this facility.

Insurance Median

$945

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: $1,390 (570%)

Insurance Median: $945 (388%)

Cash: $1,390 (570% of Medicare)

Ins. Median: $945 (388% 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 388% of the Medicare baseline (a markup of 288%). 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
Aetna	$234 - $2,427	96%
Apex	$234	96%
Blue Cross Blue Shield	$234 - $1,262	96%
Cigna	$234 - $1,713	96%
Devoted	$234	96%
Healthteam	$234	96%
UnitedHealthcare	$234 - $1,781	96%
Wellcare	$234 - $654	96%
Humana	$236 - $1,562	97%
Medicare (plans)	$236	97%
Liberty	$269	110%
Medcost	$536 - $1,899	220%
Amerihealth	$612 - $769	251%
Carolina Complete	$612 - $645	251%
Health Blue	$612 - $645	251%
Partners	$612 - $645	251%
Vaya	$618 - $652	254%
Alliance	$624 - $658	256%
Trillium	$630 - $665	258%
Ambetter / Centene	$731 - $771	300%
Oscar	$812 - $1,028	333%
Directnet	$1,599 - $1,687	656%
Cone Health	$1,894 - $1,998	777%
Healthgram	$1,894 - $1,998	777%
First Carolina Care	$2,165 - $2,284	888%
Private Healthcare Systems	$2,219 - $2,341	910%
Multiplan	$2,435 - $2,570	999%

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 $1,390.
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 North Carolina Baptist Hospital 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.