CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Ira Davenport Memorial Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,793
Cash Discount Price: $3,072
vs. Medicare Baseline: 11.46x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Ira Davenport Memorial Hospital is $2,793. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,072. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.46x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$3,072

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,793

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: $3,072 (1260%)

Insurance Median: $2,793 (1146%)

Cash: $3,072 (1260% of Medicare)

Ins. Median: $2,793 (1146% 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 1146% of the Medicare baseline (a markup of 1046%). 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
Empire	$53 - $175	22%
Blue Cross Blue Shield	$256 - $15,407	105%
Fidelis	$256	105%
Humana	$286 - $4,571	117%
Tricare	$286	117%
Amerihealth Caritas Mcr Adv - All Plans	$289	119%
UnitedHealthcare	$2,315 - $5,332	950%
Fidelis Care - Exchange - All Plans	$2,793	1146%
Geisinger - All Plans	$2,955	1212%
Cigna	$3,164	1298%
Mvp Health Plan - All Plans	$3,164	1298%
Independent Health - All Plans	$3,301	1354%
Upmc - All Plans	$3,504	1437%
Pomco Inc - All Plans	$3,656	1500%
Aetna	$3,809 - $4,533	1563%
Emblem Health - All Plans	$4,469	1833%
Emblem/Ghi	$4,692	1925%
Martins Point - All Plans	$5,078	2083%
Healthnow - All Plans	$16,727	6862%

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 $3,072.
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 Ira Davenport Memorial 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.