CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Children's Hospital of Philadelphia

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,972
Cash Discount Price: $8,658
vs. Medicare Baseline: 12.19x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Children's Hospital of Philadelphia is $2,972. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,658. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 12.19x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$8,658

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,972

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: $8,658 (3552%)

Insurance Median: $2,972 (1219%)

Cash: $8,658 (3552% of Medicare)

Ins. Median: $2,972 (1219% 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 1219% of the Medicare baseline (a markup of 1119%). 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
Geisinger Medical Assistance	$253	104%
Highmark Wholecare	$281	115%
Horizon Nj Health	$1,191	489%
Medicaid / KanCare	$1,429	586%
UnitedHealthcare	$1,437 - $1,734	589%
Health Partners	$1,632	669%
Aetna	$2,279 - $2,887	935%
Upmc Medical Assistance	$2,364	970%
Keystone First Chip	$2,684	1101%
Keystone Health Plan East	$2,738	1123%
Blue Cross Blue Shield	$3,056 - $3,468	1254%
Geisinger Health Plan Commercial	$3,989	1636%
Jefferson Health Plans	$4,095	1680%
Cigna	$4,329	1776%
Highmark	$4,329	1776%
Qualcare	$4,762	1953%
First Health Network	$5,628	2309%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$6,926	2841%
Private Health Care Systems	$6,926	2841%
Choice Care Network	$7,792	3196%

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 $8,658.
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 Children's Hospital of Philadelphia 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.