CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Blue Ridge Regional Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $2,401
  • Cash Discount Price: $5,913
  • vs. Medicare Baseline: 9.85x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Blue Ridge Regional Hospital is $2,401. 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 9.85x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
$5,913

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,401

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: $2,401 (985%)
Cash: $5,913 (2426% of Medicare)
Ins. Median: $2,401 (985% 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 985% of the Medicare baseline (a markup of 885%). 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 $946 - $992 388%
United $1,007 - $2,797 413%
Wellcare $1,022 419%
Amerihealth $1,032 423%
Partners Health Management $1,042 427%
Vaya Health $1,042 427%
Aetna $1,183 - $4,275 485%
Apex Health $1,183 485%
Cigna $2,010 - $2,418 825%
Amerihealth Caritas $2,188 898%
Caresource $2,602 1067%
Medcost $2,756 - $3,061 1131%
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: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals