CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Portsmouth Regional Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,957
Cash Discount Price: $7,613
vs. Medicare Baseline: 8.03x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Portsmouth Regional Hospital is $1,957. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,613. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.03x the Medicare baseline. Located in 333 Borthwick Ave, Portsmouth, NH.

Cash / Self-Pay

$7,613

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,957

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: $7,613 (3123%)

Insurance Median: $1,957 (803%)

Cash: $7,613 (3123% of Medicare)

Ins. Median: $1,957 (803% 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 803% of the Medicare baseline (a markup of 703%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$298 - $3,373	122%
Amerihealth Caritas	$314	129%
Well Sense Health Plan	$623	256%
Harvard Pilgrim	$793 - $992	325%
United	$1,957 - $5,025	803%
Maine Community Health	$2,381 - $4,034	977%
Cigna	$2,754 - $3,591	1130%
Tufts Health Plan	$2,862 - $4,355	1174%
Aetna	$4,819	1977%
Corvel	$5,481	2248%
Evernorth	$6,090	2498%
Mutual Of Omaha	$6,090	2498%
Multiplan	$6,167	2530%
First Health	$6,928	2842%
Healthcare Value Mgmt	$6,928	2842%
Oxford Health Plans	$7,232	2967%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $7,613.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72148.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Portsmouth Regional Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72148.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.