CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Texas Childrens Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $3,474
Cash Discount Price: $3,694
vs. Medicare Baseline: 14.25x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Texas Childrens Hospital is $3,474. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,694. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.25x the Medicare baseline. Located in 6621 Fannin Street, Houston, TX.

Cash / Self-Pay

$3,694

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,474

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: $3,694 (1515%)

Insurance Median: $3,474 (1425%)

Cash: $3,694 (1515% of Medicare)

Ins. Median: $3,474 (1425% 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 1425% of the Medicare baseline (a markup of 1325%). 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
Superior Chip	$197 - $207	81%
Driscoll Children'S Health Plan Mcd	$217	89%
First Care Health Plan	$1,489 - $3,529	611%
UnitedHealthcare	$1,489 - $3,529	611%
Molina Mcd	$1,654	679%
Blue Cross Blue Shield	$1,930 - $3,474	792%
Community Health Choice	$1,946 - $3,529	798%
Community First Health Plan Mcd	$2,206	905%
Cook Children'S Health Plan	$2,206	905%
Cigna	$3,143 - $3,529	1289%
Aetna	$3,529	1448%
Kelseycare	$3,584	1470%
Healthsmart	$3,860	1583%
Evolutions Healthcare	$4,136	1697%
First Health	$4,852 - $5,238	1990%
Multiplan	$4,963	2036%
Galaxy Health Network	$5,238	2149%

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 $3,694.
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 Texas Childrens 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.