CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Sweeny Community Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,160
Cash Discount Price: $1,200
vs. Medicare Baseline: 4.76x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Sweeny Community Hospital is $1,160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,200. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.76x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.

Cash / Self-Pay

$1,200

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,160

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: $1,200 (492%)

Insurance Median: $1,160 (476%)

Cash: $1,200 (492% of Medicare)

Ins. Median: $1,160 (476% 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 476% of the Medicare baseline (a markup of 376%). 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	$600 - $1,000	246%
Aetna	$650 - $1,160	267%
Humana	$700 - $930	287%
Cigna	$950	390%
Evercare Mcaid	$1,000	410%
UnitedHealthcare	$1,080 - $1,599	443%
Amerigroup Mcr Adv - All Other Plans	$1,160	476%
Community Hlth Choice Him - All Other Plans	$1,160	476%
Coventry Mcr Adv	$1,160	476%
Molina Mcr Adv - All Other Plans	$1,160	476%
Superior Hp Mcr Adv-All Other Plans	$1,160	476%
Wellcare Mcare - All Plans	$1,160	476%
Care Improvement Mcr - All Plans	$1,171	480%
Choicecare Mcr Adv - All Plans	$1,171	480%
Community Hlth Choice Star	$1,411	579%
Molina Mcaid	$1,411	579%
Superior Hp Mcaid	$1,411	579%
Tx Chlidrens Hp Mcaid - All Plans	$1,411	579%
Tx True Choice Mcaid - All Plans	$1,411	579%
Beech Street - All Plans	$1,499	615%
Community Care Network - All Plans	$1,599	656%
Galaxy Health Network - All Plans	$1,799	738%
Multiplan - All Plans	$1,799	738%
Evercare Mcr Adv - All Other Plans	$1,939	795%
Amerigroup Mcaid	$1,999	820%

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 $1,200.
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 Sweeny Community 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.