CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Licking Memorial Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $3,611
  • Cash Discount Price: $4,414
  • vs. Medicare Baseline: 14.81x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Licking Memorial Hospital is $3,611. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,414. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.81x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$4,414

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,611

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: $4,414 (1811%)
Insurance Median: $3,611 (1481%)
Cash: $4,414 (1811% of Medicare)
Ins. Median: $3,611 (1481% 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 1481% of the Medicare baseline (a markup of 1381%). 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
Tricare $225 92%
Aetna $230 - $3,646 94%
Blue Cross Blue Shield $230 94%
Champva [500001] $230 94%
Cigna $230 - $3,973 94%
Humana $230 - $4,282 94%
Medicare (plans) $230 94%
UnitedHealthcare $230 - $3,752 94%
Veterans Administration [100068] $230 94%
Wellcare By Allwell [450104] $230 94%
Molina Marketplace [100106] $368 151%
Medical Mutual [100114] $2,428 - $3,664 996%
Medben [700068] $3,090 - $4,326 1268%
Benicomp [70090] $3,311 1358%
Consociate Health 6 Degrees [100059] $3,531 1448%
Consociate Health [100029] $3,531 1448%
Allied Benefit Systems [100015] $3,611 1481%
Geha [100039] $3,611 1481%
Gravie Administrative Services [100165] $3,611 1481%
Meritain [100063] $3,611 1481%
Optima [700069] $3,611 1481%
Trustmark Small Business Benefits [100263] $3,611 1481%
Webtpa [100127] $3,611 1481%
Healthscope [100157] $3,752 1539%
Surest [100016] $3,752 1539%
United Medical Resources [700071] $3,752 1539%
American Postal Workers [100089] $3,973 1630%
Antidote Health Plan Of Ohio [70006803] $3,973 1630%
Coresource [100002] $3,973 - $4,414 1630%
Great West Life [700064] $3,973 1630%
National Association Of Letter Carriers [100067] $3,973 1630%
Ohio Healthy Luminare Health [100264] $3,973 1630%
Ohio Healthy [100255] $3,973 1630%
Ohio Ppo Connect [70006801] $3,973 1630%
Osu Prime Care [100254] $3,973 1630%
Quality Care Partners [70006802] $3,973 1630%
The Health Plan [100261] $3,973 1630%
Wellfleet Group, Llc [100164] $3,973 1630%
Coventry [100010] $4,074 1671%
Pan American Life [700070] $4,074 1671%
Ohio Health Choice [100109] $4,238 1739%
Administrative Concepts [100006] $4,282 1757%
Carefactor [100087] $4,282 1757%
Philadelphia American Life [100260] $4,282 - $4,414 1757%
Reliance Standard-Asrm [100258] $4,282 1757%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals