CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: UPMC Memorial

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,140
Cash Discount Price: $1,656
vs. Medicare Baseline: 4.68x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at UPMC Memorial is $1,140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,656. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.68x the Medicare baseline. Located in 1701 Innovation Drive, York, PA.

Cash / Self-Pay

$1,656

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,140

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: $1,656 (679%)

Insurance Median: $1,140 (468%)

Cash: $1,656 (679% of Medicare)

Ins. Median: $1,140 (468% 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 468% of the Medicare baseline (a markup of 368%). 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	$242 - $1,568	99%
Cigna	$243 - $1,225	100%
Geisinger	$243 - $1,994	100%
UnitedHealthcare	$245 - $2,031	101%
Amerihealth Caritas	$325	133%
Highmark Wholecare (Prev Gateway)	$325	133%
Upmc Health Plan	$333 - $1,949	137%
Health Partners Plans (Jefferson Health Plan)	$349	143%
Keystone Autism Services	$371	152%
Onecall	$400	164%
Premier Comp Solutions	$425	174%
Prime Net	$455 - $2,056	187%
Blue Cross Blue Shield	$505 - $2,123	207%
Keystone Health Plan	$552 - $2,123	226%
Upmc Work Partners	$1,305	535%
Wellspan Population Health	$1,932	793%
Multiplan	$2,346	962%

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 $1,656.
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 UPMC Memorial 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.