CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $2,181
  • Cash Discount Price: $10,369
  • vs. Medicare Baseline: 8.95x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Hospital of Univ of Pennsylvania is $2,181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,369. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.95x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$10,369

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,181

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: $10,369 (4254%)
Insurance Median: $2,181 (895%)
Cash: $10,369 (4254% of Medicare)
Ins. Median: $2,181 (895% 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 895% of the Medicare baseline (a markup of 795%). 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
Gspp And Wissahickon Hospice $125 51%
Medicaid / KanCare $187 - $10,369 77%
Kaiser Permanente $197 - $10,369 81%
Health Partners $203 - $10,369 83%
UnitedHealthcare $221 - $10,369 91%
Keystone Mercy Health Plan $240 - $10,369 98%
Blue Cross Blue Shield $251 - $6,572 103%
Medicare (plans) $251 - $256 103%
Philadelphia Va Medical Center $251 103%
Tricare $251 103%
Upmc $251 - $10,369 103%
Ibc $256 105%
Pa Medical Assistance $256 - $10,369 105%
Cigna $258 - $4,666 106%
Geisinger Health Plan $258 - $795 106%
Humana $258 - $8,295 106%
Devoted Health $263 108%
Pa Health And Wellness $263 - $414 108%
Penn Life (Living Independently For Elders) $263 108%
Aetna $266 - $10,369 109%
Clover Health Plan $271 111%
Keystone First $278 114%
Us Family Health Plan $288 118%
Gateway Health Plan $311 128%
Paired Kidney Exchange $311 128%
Elap $356 146%
Claims Watcher $401 - $451 164%
Oscar Health Plan $426 175%
Centivo $451 185%
Elap Services $466 191%
Keystone Hmo Proactive $522 214%
Highmark $527 216%
Ibc Commercial Hpn $539 221%
Penn Global Medicine $665 273%
Horizon Nj Health $1,752 - $1,823 719%
Preferred Health Care Eliance $2,281 936%
Pgm - Regie De L'Assurance Maladie Quebec $2,385 978%
Pgm - Kuwait Defense $3,629 - $4,666 1489%
Qualcare $3,940 1616%
Olympus $4,075 1672%
Coventry $4,148 - $5,288 1702%
Pgm - Chop $4,148 1702%
Wissahickon Hospice $4,148 1702%
Healthamerica/Coventry $4,666 - $5,081 1914%
First Health Global $5,184 2127%
Health Net $6,221 2552%
Pgm - Royal Embassy Of Saudi Arabia $6,221 2552%
Pgm - Embassy Of Qatar $6,740 2765%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $6,740 2765%
Interlink $6,947 2850%
Pgm - Embassy Of The United Emirates/Ipc $7,258 2977%
Health America/Ccn $8,295 3403%
Intergroup $8,295 3403%
Pgm - Kuwait Health Division $8,295 3403%
Pgm - Kuwait Oil $8,295 3403%
Preferred Care $8,295 3403%
Blue Quality Centers For Transplant (Bqct) $10,369 4254%
City Of Philadelphia Behavioral Health $10,369 4254%
Commercial Other $10,369 4254%
International Pfs $10,369 4254%
United Behavioral Health $10,369 4254%
Workers Compensation $10,369 4254%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals