CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Transylvania Regional Hospital, Inc

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $2,424
  • Cash Discount Price: $5,913
  • vs. Medicare Baseline: 9.94x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Transylvania Regional Hospital, Inc is $2,424. 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 9.94x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.
Cash / Self-Pay
$5,913

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,424

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: $2,424 (994%)
Cash: $5,913 (2426% of Medicare)
Ins. Median: $2,424 (994% 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 994% of the Medicare baseline (a markup of 894%). 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
Blue Cross Blue Shield $1,117 - $1,183 458%
United $1,134 - $2,661 465%
Wellcare $1,151 472%
Amerihealth $1,162 477%
Partners Health Management $1,173 481%
Vaya Health $1,173 481%
Apex Health $1,183 485%
Aetna $1,537 - $4,275 631%
Cigna $2,164 - $3,010 888%
Amerihealth Caritas $2,424 994%
Caresource $2,602 1067%
Medcost $3,309 - $5,026 1357%
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: 90 Hospital Drive Po Box 1116, Brevard, NC 28712
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals