CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Jfk University Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $759
Cash Discount Price: $255
vs. Medicare Baseline: 3.11x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Jfk University Medical Center is $759. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $255. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.11x the Medicare baseline. Located in 65 James Street, Edison, NJ.

Cash / Self-Pay

$255

Average discount available for prompt cash payment at this facility.

Insurance Median

$759

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: $255 (105%)

Insurance Median: $759 (311%)

Cash: $255 (105% of Medicare)

Ins. Median: $759 (311% 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 311% of the Medicare baseline (a markup of 211%). 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	$128 - $378	53%
Horizon	$242 - $3,612	99%
Wellcare	$242 - $268	99%
Aetna	$242 - $3,265	99%
Amerigroup	$242 - $268	99%
Vaccn	$242 - $268	99%
United Community/Americhoice	$254 - $281	104%
Blue Cross Blue Shield	$268	110%
Cigna	$404	166%
UnitedHealthcare	$594 - $668	244%
Oxford	$594	244%
Clover	$700	287%
Seoul Medical Group	$836	343%
Amerihealth	$845 - $935	347%
Brighton Health Plan	$2,682	1100%
Intergroup	$2,721	1116%
Activecare First McO	$2,721	1116%
Qualcare	$3,005 - $3,148	1233%
Prime Health	$3,110	1276%
Multiplan - PHCS	$3,304	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 $255.
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 Jfk University 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.