CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Punxsutawney Area Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $206
Cash Discount Price: $366
vs. Medicare Baseline: 0.85x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Punxsutawney Area Hospital is $206. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $366. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.85x the Medicare baseline. Located in 81 Hillcrest Drive, Punxsutawney, PA.

Cash / Self-Pay

$366

Average discount available for prompt cash payment at this facility.

Insurance Median

$206

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: $366 (150%)

Insurance Median: $206 (85%)

Cash: $366 (150% of Medicare)

Ins. Median: $206 (85% 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
Highmark Wholecare	$40 - $232	16%
UnitedHealthcare	$46 - $796	19%
Tricare	$60 - $226	25%
Aetna	$66 - $704	27%
Amerihealth Caritas	$66 - $245	27%
Highmark	$66 - $3,725	27%
Geisinger Health Plan	$67 - $250	27%
United Mine Workers Of America	$67 - $249	27%
Upmc Health Plan	$67 - $1,719	27%
Cigna	$68 - $1,025	28%
Ambetter / Centene	$70 - $262	29%
Pa Health And Wellness Commercial	$84 - $498	34%
Geisinger	$94 - $697	39%
Humana	$245	101%
Pa Workers Compensation	$271 - $1,726	111%

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 $366.
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 Punxsutawney Area Hospital 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.