CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Sanford Usd Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $1,611
  • Cash Discount Price: $3,555
  • vs. Medicare Baseline: 6.61x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Sanford Usd Medical Center is $1,611. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,555. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.61x the Medicare baseline. Located in 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD.
Cash / Self-Pay
$3,555

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,611

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: $3,555 (1458%)
Insurance Median: $1,611 (661%)
Cash: $3,555 (1458% of Medicare)
Ins. Median: $1,611 (661% 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 661% of the Medicare baseline (a markup of 561%). 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 $109 - $308 45%
Sanford Health Plan $196 80%
Sanford Health Plan Align $230 94%
Ucare $247 - $3,124 101%
Aetna $249 - $3,400 102%
Health Partners $249 - $1,733 102%
Medicare (plans) $249 102%
UnitedHealthcare $249 - $3,915 102%
Primewest $254 - $257 104%
Security Health Plan $2,444 1003%
Medica $2,995 - $3,204 1229%
First Choice Health Network $4,000 1641%
Healthez $4,000 1641%
Multiplan $4,000 1641%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD 57117
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals