CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Nacogdoches Memorial Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,291
Cash Discount Price: $704
vs. Medicare Baseline: 5.30x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Nacogdoches Memorial Hospital is $1,291. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $704. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.30x the Medicare baseline. Located in 1204 Mound St, Nacogdoches, TX.

Cash / Self-Pay

$704

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,291

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: $704 (289%)

Insurance Median: $1,291 (530%)

Cash: $704 (289% of Medicare)

Ins. Median: $1,291 (530% 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 530% of the Medicare baseline (a markup of 430%). 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
Blue Cross Blue Shield	$222 - $1,878	91%
Humana	$227	93%
Wellmed	$227 - $2,347	93%
Healthspring	$238	98%
Molina	$238 - $2,347	98%
Galaxy	$263 - $1,526	108%
Usa Health Network	$283 - $1,643	116%
Aetna	$323 - $1,878	133%
Healthsmart	$323 - $1,878	133%
Phcs	$323 - $1,878	133%
Hiet Benefit Plan	$404 - $2,347	166%
UnitedHealthcare	$752	308%

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 $704.
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 Nacogdoches Memorial Hospital 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.