CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Adventist Health Portland

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $787
  • Cash Discount Price: $1,040
  • vs. Medicare Baseline: 3.23x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Adventist Health Portland is $787. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,040. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.23x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$1,040

Average discount available for prompt cash payment at this facility.

Insurance Median
$787

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: $1,040 (427%)
Insurance Median: $787 (323%)
Cash: $1,040 (427% of Medicare)
Ins. Median: $787 (323% 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 323% of the Medicare baseline (a markup of 223%). 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
Pacific Source Comm - All Plans $202 83%
Ods - All Plans $212 87%
Care Oregon - All Plans $225 92%
Kaiser Mcr Adv $265 109%
Humana $271 - $281 111%
Moda Mcr Adv $281 115%
UnitedHealthcare $281 - $1,949 115%
Healthnet Mcr Adv $305 125%
Ah Employee Health Plan - All Plans $477 196%
Moda Conn Oebb/Syn Pebb $530 217%
Regence Ohsu Plus $550 226%
Moda Affinity - All Other Plans $610 250%
Regence - All Other Plans $611 251%
Providence Hp - All Plans $643 264%
Kaiser - All Other Plans $692 284%
Healthcare Resources - All Plans $730 299%
Regence Preferred Mcr Adv $787 323%
Moda Select $830 340%
Moda Connexus $939 385%
Moda Synergy $993 407%
Regence Mcr Adv $995 408%
Workers Comp $1,124 461%
Bc Premera First - All Plans $1,624 666%
Worldventure - All Plans $1,949 800%
Cigna $2,100 861%
First Choice - All Plans $2,252 924%
Multiplan - All Plans $2,437 1000%
Phcs - All Plans $2,437 1000%
Aetna $2,540 1042%
First Health-Coventry - All Plans $2,599 1066%
National Provider Network - All Plans $2,859 1173%
Health Payors Organization Ltd- All Plans $2,924 1199%
Moda Ohsu Ppo/Epo/Hmc $5,848 2399%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals