CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Adena Regional Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,602
Cash Discount Price: $1,144
vs. Medicare Baseline: 6.57x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Adena Regional Medical Center is $1,602. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,144. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.57x the Medicare baseline. Located in 272 Hospital Road, Chillicothe, OH.

Cash / Self-Pay

$1,144

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,602

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: $1,144 (469%)

Insurance Median: $1,602 (657%)

Cash: $1,144 (469% of Medicare)

Ins. Median: $1,602 (657% 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 657% of the Medicare baseline (a markup of 557%). 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
Aetna	$230 - $2,020	94%
Buckeye Community Health Plan	$230	94%
Humana	$230 - $2,174	94%
Medical Mutual Of Ohio	$230 - $1,509	94%
Medigold	$230	94%
Molina	$230	94%
UnitedHealthcare	$230 - $1,796	94%
Care Source	$235	96%
Gateway Health	$235	96%
Molina Marketplace	$380	156%
Care Source Just4Me	$415	170%
Sidecar Health	$633	260%
Cigna	$1,085 - $1,417	445%
Blue Cross Blue Shield	$1,398 - $1,912	573%
Ohio Ppo Connect	$1,602	657%
The Health Plan	$1,602	657%
First Health	$1,794 - $2,000	736%
Ohio Health Choice	$1,822	747%
Healthsmart	$1,945	798%
Integrated Health Plan	$2,174	892%
Multiplan/Private Healthcare Systems	$2,174	892%
Three Rivers Network	$2,174	892%

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 $1,144.
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 Adena Regional Medical Center 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.