CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Spring Valley Hospital Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,202
Cash Discount Price: $3,923
vs. Medicare Baseline: 4.93x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Spring Valley Hospital Medical Center is $1,202. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,923. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.93x the Medicare baseline. Located in 5400 South Rainbow Blvd, Las Vegas, NV.

Cash / Self-Pay

$3,923

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,202

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: $3,923 (1609%)

Insurance Median: $1,202 (493%)

Cash: $3,923 (1609% of Medicare)

Ins. Median: $1,202 (493% 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 493% of the Medicare baseline (a markup of 393%). 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	$257 - $396	105%
Smart_Choice	$257	105%
Silver_Summit	$262	107%
Molina	$265	109%
Cigna	$335 - $480	137%
United_Healthcare	$524	215%
Prominence	$1,095 - $1,941	449%
Humana	$1,202	493%
Sierra_Health_Options	$1,485 - $2,302	609%
Aetna	$1,980 - $3,756	812%
Sierra_Health_Plan_Of_Nevada	$2,469 - $3,828	1013%
Multiplan	$4,461 - $6,916	1830%

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 $3,923.
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 Spring Valley Hospital 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.