CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Sanford Hillsboro

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $2,271
  • Cash Discount Price: $2,202
  • vs. Medicare Baseline: 9.32x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Sanford Hillsboro is $2,271. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,202. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.32x the Medicare baseline. Located in 12 Third Street Se, Hillsboro, ND.
Cash / Self-Pay
$2,202

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,271

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: $2,202 (903%)
Insurance Median: $2,271 (932%)
Cash: $2,202 (903% of Medicare)
Ins. Median: $2,271 (932% 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 932% of the Medicare baseline (a markup of 832%). 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 $578 - $1,787 237%
Sanford Health Plan Align $1,255 515%
Ucare $1,349 - $2,419 553%
Aetna $1,360 - $2,392 558%
Health Partners $1,360 - $2,147 558%
Medicare (plans) $1,360 558%
UnitedHealthcare $1,360 - $2,299 558%
Primewest $1,388 569%
Security Health Plan $1,514 621%
Sanford Health Plan $2,173 - $2,557 891%
Medica $2,271 - $2,428 932%
First Choice Health Network $2,478 1017%
Healthez $2,478 1017%
Multiplan $2,478 1017%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 Third Street Se, Hillsboro, ND 58045
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals