CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Texas Health Presbyterian Hospital Rockwall

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,626
Cash Discount Price: $2,394
vs. Medicare Baseline: 6.67x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Texas Health Presbyterian Hospital Rockwall is $1,626. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,394. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.67x the Medicare baseline. Located in 3150 Horizon Road, Rockwall, TX.

Cash / Self-Pay

$2,394

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,626

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: $2,394 (982%)

Insurance Median: $1,626 (667%)

Cash: $2,394 (982% of Medicare)

Ins. Median: $1,626 (667% 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 667% of the Medicare baseline (a markup of 567%). 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
Amerigroup	$197 - $252	81%
Blue Cross Blue Shield	$197 - $1,652	81%
Parkland	$197	81%
UnitedHealthcare	$197 - $1,933	81%
Superior Wellcare	$207 - $264	85%
Molina	$213 - $252	87%
American Health	$240	98%
Healthspring	$244	100%
Humana	$249	102%
Fort Worth Firefighters	$1,105 - $2,436	453%
Aetna	$1,200 - $2,797	492%
City Of Fort Worth	$1,875	769%
Cigna	$1,973 - $3,755	809%
Quick Trip	$2,394 - $2,514	982%
Phcs	$2,773 - $2,973	1138%
Healthsmart	$2,993 - $3,352	1228%
Multiplan	$3,472	1424%
Galaxy	$3,511	1440%
Usa	$3,511	1440%

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 $2,394.
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 Health Presbyterian Hospital Rockwall 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.