CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: St Luke's Hospital - Carbon Campus

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $522
  • Cash Discount Price: $6,378
  • vs. Medicare Baseline: 2.14x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at St Luke's Hospital - Carbon Campus is $522. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,378. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.14x the Medicare baseline. Located in 500 St Luke's Drive, Lehighton, PA.
Cash / Self-Pay
$6,378

Average discount available for prompt cash payment at this facility.

Insurance Median
$522

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: $6,378 (2616%)
Insurance Median: $522 (214%)
Cash: $6,378 (2616% of Medicare)
Ins. Median: $522 (214% 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 214% of the Medicare baseline (a markup of 114%). 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
Blue Cross Blue Shield $241 - $2,431 99%
Highmark $241 - $676 99%
Aetna $245 - $2,682 101%
Geisinger $245 - $2,161 101%
Humana $250 103%
Upmc Health Plan $253 - $2,106 104%
UnitedHealthcare $260 - $2,221 107%
Highmark Wholecare $295 121%
Amerihealth Caritas $307 126%
Jefferson Health Plan $369 151%
Oscar $1,994 818%
Cigna $2,103 863%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 St Luke's Drive, Lehighton, PA 18235
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals