CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Sanford Canton-Inwood Medical Center - Cah

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,767
Cash Discount Price: $2,981
vs. Medicare Baseline: 11.35x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Sanford Canton-Inwood Medical Center - Cah is $2,767. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,981. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.35x the Medicare baseline. Located in 440 North Hiawatha Drive, Canton, SD.

Cash / Self-Pay

$2,981

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,767

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: $2,981 (1223%)

Insurance Median: $2,767 (1135%)

Cash: $2,981 (1223% of Medicare)

Ins. Median: $2,767 (1135% 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 1135% of the Medicare baseline (a markup of 1035%). 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
Sanford Health Plan Align	$1,274	523%
Ucare	$1,367 - $3,274	561%
Wellmark	$1,367 - $3,242	561%
Aetna	$1,382 - $3,238	567%
Health Partners	$1,382 - $2,794	567%
Medicare (plans)	$1,382	567%
UnitedHealthcare	$1,382 - $3,111	567%
Primewest	$1,408	578%
Sanford Health Plan	$2,041 - $2,739	837%
Security Health Plan	$2,049	841%
Medica	$3,074 - $3,286	1261%
First Choice Health Network	$3,353	1375%
Healthez	$3,353	1375%
Multiplan	$3,353	1375%

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 $2,981.
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 Sanford Canton-Inwood Medical Center - 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.