CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Atrium Health Pineville

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $428
Cash Discount Price: $2,013
vs. Medicare Baseline: 1.76x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Atrium Health Pineville is $428. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,013. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.76x the Medicare baseline. Located in 10628 Park Rd, Charlotte, NC.

Cash / Self-Pay

$2,013

Average discount available for prompt cash payment at this facility.

Insurance Median

$428

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: $2,013 (826%)

Insurance Median: $428 (176%)

Cash: $2,013 (826% of Medicare)

Ins. Median: $428 (176% 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.

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
Trillium	$61 - $429	25%
Alliance	$62 - $427	25%
Amerihealth Caritas	$62 - $411	25%
Carolina Complete Health	$62 - $416	25%
Healthy Blue	$62 - $416	25%
Partners	$62 - $411	25%
UnitedHealthcare	$62 - $1,896	25%
Vaya	$62 - $420	25%
Wellcare	$62 - $416	25%
Cigna	$66 - $2,718	27%
Humana	$67 - $234	27%
Aetna	$68 - $3,342	28%
Ortho Carolina	$82 - $287	34%
Medcost	$354 - $2,408	145%
Blue Cross Blue Shield	$795 - $1,295	326%
Ambetter / Centene	$1,170 - $1,461	480%
Employers Health Network	$1,780	730%
Physician Reach Out	$2,013	826%
Magellan	$2,416	991%
Gmmi	$2,617	1074%
Quik Trip	$2,617	1074%
Choicecare	$2,899 - $2,979	1189%
Healthgram	$3,221	1321%
Provider Select	$3,261 - $3,624	1338%
Private Health Care Systems	$3,301	1354%
First Health	$3,342	1371%
Beechstreet	$3,624	1487%
Multiplan	$3,704	1519%

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 $2,013.
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 Atrium Health Pineville 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.