CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Schuylkill Medical Center - South Jackson Street

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $304
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Schuylkill Medical Center - South Jackson Street is $304. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.25x the Medicare baseline. Located in 420 South Jackson Street, Pottsville, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$304

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%)

Insurance Median: $304 (125%)

Ins. Median: $304 (125% 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.

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
Blue Cross Blue Shield	$239 - $2,076	98%
Geisinger	$244 - $581	100%
Highmark Blue Shield	$244 - $755	100%
Amerihealth	$246	101%
Cigna	$246 - $597	101%
UnitedHealthcare	$248 - $302	102%
Aetna	$251 - $1,324	103%
Jefferson Health Partners	$251 - $478	103%
Devoted Health	$253	104%
Humana	$253	104%
Upmc	$253 - $1,163	104%
Gateway	$255	105%
Emblem	$258 - $1,065	106%
Pa Health & Wellness (Allwell)	$263	108%
Amerihealth Caritas	$295	121%
Highmark Wholecare/Gateway	$325	133%
Pa Health & Wellness	$346	142%
Ambetter / Centene	$724	297%
Valley Preferred	$1,392	571%

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 $X.
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 Schuylkill Medical Center - South Jackson Street 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.