CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Elizabethtown Community Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $292
Cash Discount Price: $2,019
vs. Medicare Baseline: 1.20x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Elizabethtown Community Hospital is $292. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,019. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.20x the Medicare baseline. Located in 75 Park Street, Elizabethtown, NY.

Cash / Self-Pay

$2,019

Average discount available for prompt cash payment at this facility.

Insurance Median

$292

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: $2,019 (828%)

Insurance Median: $292 (120%)

Cash: $2,019 (828% of Medicare)

Ins. Median: $292 (120% 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
Capital District Physicians' Health Plan	$123 - $3,148	50%
UnitedHealthcare	$126 - $3,527	52%
Fidelis Care	$153 - $1,455	63%
Blue Cross Blue Shield	$162 - $2,879	66%
Harvard Pilgrim	$166 - $3,064	68%
Magnacare	$166 - $3,064	68%
Humana	$171 - $230	70%
Coventry	$176 - $3,256	72%
Aetna	$180 - $2,872	74%
Martins Point	$180 - $1,455	74%
Mvp	$180 - $2,992	74%
Veterans Affairs Community Care Network	$180 - $1,455	74%
Multiplan	$186 - $3,447	76%
Choicecare	$199 - $3,064	82%
Wellpath	$253 - $2,183	104%
Highmark Blueshield	$264 - $3,121	108%
Emblem Health	$3,064	1257%

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 $2,019.
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 Elizabethtown Community 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.