CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Tristar Summit Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $847
Cash Discount Price: $10,093
vs. Medicare Baseline: 3.47x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Tristar Summit Medical Center is $847. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,093. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.47x the Medicare baseline. Located in 5655 Frist Blvd, Hermitage, TN.

Cash / Self-Pay

$10,093

Average discount available for prompt cash payment at this facility.

Insurance Median

$847

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: $10,093 (4140%)

Insurance Median: $847 (347%)

Cash: $10,093 (4140% of Medicare)

Ins. Median: $847 (347% 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 347% of the Medicare baseline (a markup of 247%). 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
Humana	$277 - $6,561	114%
United	$314 - $4,542	129%
Blue Cross Blue Shield	$504 - $937	207%
Aetna	$530 - $5,047	217%
Kentucky Labor Cabinet	$1,858	762%
Apex Health	$1,918	787%
Nhc Advantage, Inc.	$1,918	787%
Pruitt Health (Allyalign)	$1,918	787%
Cigna	$3,290 - $8,075	1350%
Bgfh Singlesource	$5,047 - $8,579	2070%
Multiplan	$6,561	2691%
Employers Health Network	$7,065	2898%
Compsych	$8,075	3313%
Beech Street	$8,882	3644%
Prime Health	$8,882	3644%

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 $10,093.
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 Tristar Summit 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.