CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Sanford Vermillion Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,974
Cash Discount Price: $3,374
vs. Medicare Baseline: 12.20x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Sanford Vermillion Medical Center is $2,974. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,374. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 12.20x the Medicare baseline. Located in 20 South Plum Street, Vermillion, SD.

Cash / Self-Pay

$3,374

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,974

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: $3,374 (1384%)

Insurance Median: $2,974 (1220%)

Cash: $3,374 (1384% of Medicare)

Ins. Median: $2,974 (1220% 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 1220% of the Medicare baseline (a markup of 1120%). 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	$1,244	510%
Wellmark Sd	$1,282	526%
Ucare	$1,375 - $3,706	564%
Aetna	$1,392 - $3,665	571%
Health Partners	$1,392 - $3,164	571%
Medicare (plans)	$1,392	571%
UnitedHealthcare	$1,392 - $3,522	571%
Primewest	$1,417	581%
Sanford Health Plan	$1,670 - $2,240	685%
Security Health Plan	$2,320	952%
Medica	$3,480 - $3,720	1428%
Wellmark	$3,627 - $3,670	1488%
First Choice Health Network	$3,796	1557%
Healthez	$3,796	1557%
Multiplan	$3,796	1557%

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 $3,374.
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 Vermillion Medical Center 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.