CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $123
Cash Discount Price: $2,001
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at The University of Vermont Health Network-Alice Hy is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,001. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.50x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$2,001

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $2,001 (821%)

Insurance Median: $123 (50%)

Cash: $2,001 (821% of Medicare)

Ins. Median: $123 (50% 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
Blue Cross Blue Shield	$33 - $1,252	14%
Capital District Physicians' Health Plan	$45 - $3,675	18%
UnitedHealthcare	$46 - $3,854	19%
Fidelis Care	$56 - $1,252	23%
Humana	$56 - $1,252	23%
Aetna	$66 - $3,365	27%
Martins Point	$66 - $1,252	27%
Mvp	$66 - $1,806	27%
Veterans Affairs Community Care Network	$66 - $1,252	27%
Choicecare	$70 - $2,935	29%
Magnacare	$70 - $3,130	29%
Highmark Blueshield	$86 - $3,506	35%
St. Regis	$178 - $1,252	73%

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 $2,001.
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 The University of Vermont Health Network-Alice Hy 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.