CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Wellspan Surgery and Rehabilitation Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,166
Cash Discount Price: $454
vs. Medicare Baseline: 4.78x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Wellspan Surgery and Rehabilitation Hospital is $1,166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $454. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.78x the Medicare baseline. Located in 55 Monument Road, York, PA.

Cash / Self-Pay

$454

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,166

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: $454 (186%)

Insurance Median: $1,166 (478%)

Cash: $454 (186% of Medicare)

Ins. Median: $1,166 (478% 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 478% of the Medicare baseline (a markup of 378%). 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
Johns_Hopkins_Healthcare_Plan	$234 - $2,114	96%
Medicaid / KanCare	$234 - $410	96%
Medicare (plans)	$234 - $282	96%
Aetna	$241 - $1,969	99%
Highmark	$358 - $1,166	147%
Wellspan_Capital_Blue_Cross	$466	191%
Blue_Cross	$1,249 - $1,994	512%
United_Healthcare	$1,342	551%
First_Health_Network	$1,856 - $1,969	761%
Cigna	$1,982 - $1,994	813%
Upmc	$2,069	849%
Geisinger	$2,084	855%
Phc	$2,114 - $2,158	867%

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 $454.
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 Wellspan Surgery and Rehabilitation 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.