CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Ascension St John Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $241
  • Cash Discount Price: $925
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Ascension St John Medical Center is $241. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $925. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.99x the Medicare baseline. Located in 1923 South Utica Avenue, Tulsa, OK.
Cash / Self-Pay
$925

Average discount available for prompt cash payment at this facility.

Insurance Median
$241

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: $925 (379%)
Insurance Median: $241 (99%)
Cash: $925 (379% of Medicare)
Ins. Median: $241 (99% 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.

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
First Health $93 - $587 38%
Aetna $151 - $1,591 62%
Champva $230 94%
Community Care - St John Network Senior - Govt $230 94%
Communitycare Senior $230 94%
Life Pace $230 94%
Longevity Health Plan Of Oklahoma $230 94%
Medicare (plans) $230 94%
UnitedHealthcare $230 - $920 94%
Va Community Care Network $230 94%
Veterans Administration $230 94%
Humana $232 95%
Blue Cross Blue Shield $241 - $667 99%
Communitycare (Standard) $253 104%
Community Care (Select) 7/1/13 $276 113%
Ccl&H $299 123%
Smarthealth $322 132%
Community Care Smarthealth $345 - $552 142%
Communitycare (Select) $345 - $529 142%
Connect Health Benefit $460 189%
Evolutions $460 189%
Kempton Group Administrators $517 212%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1923 South Utica Avenue, Tulsa, OK 74104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals