CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: South Pointe Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $632
  • Cash Discount Price: $983
  • vs. Medicare Baseline: 2.59x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at South Pointe Hospital is $632. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $983. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.59x the Medicare baseline. Located in 20000 Harvard Road, Warrensville Heights, OH.
Cash / Self-Pay
$983

Average discount available for prompt cash payment at this facility.

Insurance Median
$632

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: $983 (403%)
Insurance Median: $632 (259%)
Cash: $983 (403% of Medicare)
Ins. Median: $632 (259% 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 259% of the Medicare baseline (a markup of 159%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
United $213 - $518 87%
Aetna $224 - $1,513 92%
Blue Cross Blue Shield $224 - $1,116 92%
Devoted Health $224 92%
Humana $224 - $1,286 92%
Summacare $224 - $566 92%
The Health Plan $224 - $908 92%
UnitedHealthcare $224 - $938 92%
Upmc $224 - $908 92%
Valor $224 92%
Cigna $231 - $1,355 95%
Communicare $235 96%
Perennial Health $242 99%
Pphp $246 101%
Paramount $250 103%
Buckeye $255 105%
Molina $255 105%
Caresource $259 106%
Amerihealth $267 110%
Oscar $456 - $582 187%
Cc Ehp $604 - $613 248%
Aultcare $651 267%
Ohcp $735 302%
Omas $756 310%
Ohio Healthy $817 335%
Healthsmart $832 341%
Mmo $862 - $1,814 354%
Php $908 372%
Gms $1,059 434%
Medical Benefit Corp $1,059 434%
Quality Care Partners $1,059 434%
Consociate Health $1,135 466%
Frontpath $1,362 559%
Managed Care Services $1,362 559%
Multiplan $1,362 559%
Tertiary Care Network $1,362 559%
Three Rivers $1,362 559%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 20000 Harvard Road, Warrensville Heights, OH 44122
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals