CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Essentia Health

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $1,299
  • Cash Discount Price: $2,165
  • vs. Medicare Baseline: 5.33x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Essentia Health is $1,299. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,165. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.33x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$2,165

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,299

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: $2,165 (888%)
Insurance Median: $1,299 (533%)
Cash: $2,165 (888% of Medicare)
Ins. Median: $1,299 (533% 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 533% of the Medicare baseline (a markup of 433%). 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
Primewest $236 97%
Advocare/Security Health $242 99%
Blue Cross Blue Shield $242 - $1,948 99%
Freedom Blue Ppo $242 99%
Healthpartners Care Msho / Mcr Adv $242 99%
Imcare Msho Pcc Prime $242 99%
Imcare Msho Ref Req $242 99%
Itasca Med Care $242 99%
Medica Advantage Solutions $242 99%
Medica Msho/Dual Solutions $242 99%
Medica Prime Solution Group $242 99%
Medicare (plans) $242 99%
Nd Va Administration $242 99%
Platinum Blue/Vantage Blue $242 99%
Primewest Msho $242 99%
Secure Blue Msho $242 99%
Ubh Cost Plan $242 99%
Ubh Msho $242 99%
Ucare Msho $242 99%
UnitedHealthcare $242 - $2,300 99%
Sanford Health Plan $428 - $1,303 176%
Medica Access $773 317%
Healthpartners Care Pmap $1,123 461%
Medica $1,599 - $1,778 656%
Medica Uplan $1,599 656%
Medica Choice $1,830 751%
Ucare $1,899 779%
Cigna $1,934 793%
Healthpartners $1,934 793%
Healthpartners Pcc Prime $1,934 793%
Wea $2,078 - $2,222 852%
America'S Ppo $2,237 918%
Wps $2,395 - $2,424 982%
Aetna $2,453 1006%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals