CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Pender Memorial Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,116
Cash Discount Price: $1,515
vs. Medicare Baseline: 4.58x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Pender Memorial Hospital is $1,116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,515. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.58x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$1,515

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,116

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: $1,515 (621%)

Insurance Median: $1,116 (458%)

Cash: $1,515 (621% of Medicare)

Ins. Median: $1,116 (458% 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 458% of the Medicare baseline (a markup of 358%). 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
Blue Cross Blue Shield	$399 - $1,473	164%
Humana	$703 - $3,434	288%
Pace Of The Southern Piedmont	$740 - $1,078	304%
New Hanover Health	$755 - $1,100	310%
Aetna	$759 - $3,394	311%
Cigna	$763 - $1,761	313%
Carolina Complete	$770 - $1,122	316%
Nc Department Of Public Safety	$770 - $2,156	316%
Amerihealth	$786 - $1,144	322%
Wellcare	$786 - $1,144	322%
Ambetter / Centene	$1,036 - $1,509	425%
Liberty Health	$1,052 - $1,531	432%
Caresource North Carolina	$1,097 - $1,597	450%
Plotkin Health	$1,645 - $2,396	675%
UnitedHealthcare	$2,002 - $2,915	821%
Medcost	$2,065 - $3,350	847%
Employers Choice Network	$2,660 - $3,873	1091%
Three Rivers Provider Network	$2,660 - $3,873	1091%

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 $1,515.
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 Pender Memorial 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.