CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Glens Falls Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $697
Cash Discount Price: $594
vs. Medicare Baseline: 2.86x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Glens Falls Hospital is $697. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $594. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.86x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.

Cash / Self-Pay

$594

Average discount available for prompt cash payment at this facility.

Insurance Median

$697

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: $594 (244%)

Insurance Median: $697 (286%)

Cash: $594 (244% of Medicare)

Ins. Median: $697 (286% 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 286% of the Medicare baseline (a markup of 186%). 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
Aetna	$74 - $615	30%
Cdphp	$190 - $1,206	78%
Blue Shield	$210 - $621	86%
Mvp Commercial	$214 - $554	88%
Blue Cross Blue Shield	$252 - $789	103%
Mvp	$536 - $1,126	220%
Fidelis	$590 - $1,206	242%
Hamaspik	$755 - $789	310%
Nascentia Health Options	$755 - $789	310%
Magnacare	$872 - $910	358%
Emblem	$930 - $971	382%
Empire Plan Nyship	$988 - $1,032	405%
Multiplan	$988 - $1,032	405%
UnitedHealthcare	$988 - $1,032	405%

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 $594.
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 Glens Falls 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.