CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Pioneer Memorial Hospital - Cah

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $3,896
Cash Discount Price: $4,584
vs. Medicare Baseline: 15.98x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Pioneer Memorial Hospital - Cah is $3,896. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,584. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 15.98x the Medicare baseline. Located in 315 N Washington Ave Post Office Box 368, Viborg, SD.

Cash / Self-Pay

$4,584

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,896

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: $4,584 (1880%)

Insurance Median: $3,896 (1598%)

Cash: $4,584 (1880% of Medicare)

Ins. Median: $3,896 (1598% 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 1598% of the Medicare baseline (a markup of 1498%). 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
UnitedHealthcare	$1,604 - $3,851	658%
Aetna	$3,621	1485%
Health Partners	$3,805	1561%
United Medical Resources	$3,851	1580%
Avera Health Plan	$3,896	1598%
Cigna	$3,896	1598%
Dakotacare	$3,896	1598%
Medica	$3,896	1598%
Sanford Health Plan	$4,126	1693%
Blue Cross Blue Shield	$4,401	1805%

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 $4,584.
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 Pioneer Memorial Hospital - Cah 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.