CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Crouse Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $385
Cash Discount Price: $900
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Crouse Hospital is $385. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $900. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.58x the Medicare baseline. Located in 736 Irving Avenue, Syracuse, NY.

Cash / Self-Pay

$900

Average discount available for prompt cash payment at this facility.

Insurance Median

$385

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: $900 (369%)

Insurance Median: $385 (158%)

Cash: $900 (369% of Medicare)

Ins. Median: $385 (158% 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.

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
Excellus	$260 - $535	107%
Aetna	$298 - $304	122%
Brighton Healthplan	$298 - $385	122%
Cdphp	$298	122%
Emblemhealth	$298	122%
Fidelis	$298 - $866	122%
Humana	$298	122%
Martins Point	$298	122%
Mvp	$298 - $866	122%
Nascentia	$298	122%
UnitedHealthcare	$298 - $385	122%
Mycompass	$307 - $396	126%
Wellcare	$313 - $462	128%
Healthfirst Health Plan	$385 - $423	158%
Molina	$385 - $866	158%
Emblem Health	$670	275%

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 $900.
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 Crouse 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.