CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Freestone Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $1,649
  • Cash Discount Price: $4,134
  • vs. Medicare Baseline: 6.76x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Freestone Medical Center is $1,649. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,134. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.76x the Medicare baseline. Located in 125 Newman St, Fairfield, TX.
Cash / Self-Pay
$4,134

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,649

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: $4,134 (1696%)
Insurance Median: $1,649 (676%)
Cash: $4,134 (1696% of Medicare)
Ins. Median: $1,649 (676% 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 676% of the Medicare baseline (a markup of 576%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $164 - $4,000 67%
Gilsbar $216 - $5,905 89%
Mcaid $294 - $1,240 121%
Misc Mcaid Hmo $294 - $1,772 121%
Superior Health Chip $294 - $1,240 121%
Tx Childrens Mcaid $294 - $1,240 121%
UnitedHealthcare $294 - $1,772 121%
Amerigroup $350 - $1,772 144%
Medicaid / KanCare $350 - $2,728 144%
Rightcare S&W Mcaid $350 - $1,772 144%
Superior Health Mcd $350 - $2,728 144%
Aarp $429 176%
Apwu $429 176%
Fringe Benefits $429 176%
Geha $429 176%
Uhcss $429 176%
Aetna $1,302 - $4,724 534%
Cigna $3,543 1453%
Misc Multiplan $4,134 1696%
Misc Multiplan Auto $4,134 1696%
Misc Multiplan Workcomp $4,134 1696%
Self Pay Gt 083123 $4,134 1696%
Self Pay Lt 090123 $4,134 1696%
Aflac $5,905 2422%
Bankers Life $5,905 2422%
Fairview Nursing Home $5,905 2422%
Humana $5,905 2422%
Icare $5,905 2422%
Inmate Freestone Co $5,905 2422%
Misc Hospice $5,905 2422%
Miscellaneous $5,905 2422%
Miscellaneous Auto $5,905 2422%
Mutual Of Omaha $5,905 2422%
North American Med Empl $5,905 2422%
Standard Life Insurance $5,905 2422%
Tml $5,905 2422%
Zelis Healthcare $5,905 2422%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Newman St, Fairfield, TX 75840
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals