CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $387
  • Cash Discount Price: $2,908
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Montefiore Mount Vernon Hospital is $387. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,908. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.59x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
$2,908

Average discount available for prompt cash payment at this facility.

Insurance Median
$387

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: $2,908 (1193%)
Insurance Median: $387 (159%)
Cash: $2,908 (1193% of Medicare)
Ins. Median: $387 (159% 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.

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
Healthfirst $199 - $808 82%
Metroplus $217 - $387 89%
Blue Cross Blue Shield $298 122%
Emblem $298 - $3,579 122%
Fidelis $298 - $884 122%
Point Comfort $298 122%
UnitedHealthcare $298 - $518 122%
Villagecaremax $298 122%
Vnsny Choice $298 - $581 122%
Wellcare $304 - $515 125%
Centerlight $307 - $328 126%
Elderplan $307 126%
Partners Health Plan $313 128%
Longevity $325 133%
Humana $328 135%
Molina Healthcare Of Ny Affinity $411 169%
Oscar $471 193%
Medicaid / KanCare $505 207%
American Postal Workers $518 212%
Vnsny Select Health $581 238%
Aetna $596 - $666 244%
Mvp $608 249%
Northwell $801 329%
Centivo $2,819 1156%
Cigna $4,141 - $4,601 1699%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals