CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Highlands Cashiers Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $2,643
  • Cash Discount Price: $5,913
  • vs. Medicare Baseline: 10.84x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Highlands Cashiers Hospital is $2,643. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,913. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.84x the Medicare baseline. Located in 190 Hospital Drive, Highlands, NC.
Cash / Self-Pay
$5,913

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,643

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: $5,913 (2426%)
Insurance Median: $2,643 (1084%)
Cash: $5,913 (2426% of Medicare)
Ins. Median: $2,643 (1084% 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 1084% of the Medicare baseline (a markup of 984%). 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
Apex Health $1,183 485%
Cigna $1,940 - $2,625 796%
Blue Cross Blue Shield $2,012 - $2,129 825%
United $2,042 - $3,583 838%
Wellcare $2,073 850%
Amerihealth $2,093 859%
Partners Health Management $2,113 867%
Vaya Health $2,113 867%
Amerihealth Caritas $2,247 922%
Caresource $2,602 1067%
Medcost $2,773 - $3,336 1138%
Aetna $2,838 - $4,299 1164%
Magellan $3,548 1455%
Magellan Behavioral Health $3,548 1455%
Multiplan $4,730 1940%
Avalon Administrative Services $5,026 2062%
Prime Health $5,204 - $5,322 2135%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 190 Hospital Drive, Highlands, NC 28741
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals