CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Ocean Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $799
Cash Discount Price: $253
vs. Medicare Baseline: 3.28x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Ocean Medical Center is $799. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $253. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.28x the Medicare baseline. Located in 425 Jack Martin Blvd, Brick, NJ.

Cash / Self-Pay

$253

Average discount available for prompt cash payment at this facility.

Insurance Median

$799

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: $253 (104%)

Insurance Median: $799 (328%)

Cash: $253 (104% of Medicare)

Ins. Median: $799 (328% 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 328% of the Medicare baseline (a markup of 228%). 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
Karna	$124 - $378	51%
Aetna	$242 - $3,476	99%
Amerigroup	$242	99%
Horizon	$242 - $3,665	99%
Vaccn	$242 - $264	99%
Wellcare	$242 - $264	99%
United Community/Americhoice	$254 - $277	104%
Blue Cross Blue Shield	$264	108%
UnitedHealthcare	$317 - $951	130%
Cigna	$394 - $404	162%
Oxford	$560	230%
Activecare First McO	$650 - $2,721	267%
Clover	$799	328%
Seoul Medical Group	$836 - $861	343%
Amerihealth	$945 - $961	388%
Qualcare	$2,083 - $3,291	854%
Intergroup	$2,721	1116%
Brighton Health Plan	$3,063	1257%
Prime Health	$3,110	1276%
Multiplan - PHCS	$3,304 - $3,773	1355%
Bergen Risk	$4,332	1777%

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 $253.
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 Ocean Medical Center 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.