CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Holy Cross Hospital-Davis

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,709
Cash Discount Price: $2,129
vs. Medicare Baseline: 11.11x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Holy Cross Hospital-Davis is $2,709. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,129. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.11x the Medicare baseline. Located in 1600 West Antelope Drive, Layton, UT.

Cash / Self-Pay

$2,129

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,709

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: $2,129 (873%)

Insurance Median: $2,709 (1111%)

Cash: $2,129 (873% of Medicare)

Ins. Median: $2,709 (1111% 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 1111% of the Medicare baseline (a markup of 1011%). 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
Select Health	$85 - $2,616	35%
Medicaid / KanCare	$96	39%
Uuhp	$96 - $937	39%
Humana	$110	45%
Medicare (plans)	$110	45%
Employer Direct Healthcare	$138	57%
Motivhealth	$146	60%
Blue Cross Blue Shield	$233 - $3,194	96%
Molina	$259 - $2,286	106%
Cigna	$490 - $4,258	201%
Centura Employee Plan	$543	223%
Pehp	$2,273 - $3,087	932%
Aetna	$2,352 - $4,498	965%
Wise	$2,768 - $2,821	1135%
Deseret Mutual Benefit Administrators	$3,268	1341%
Multiplan	$3,673 - $4,844	1507%
UnitedHealthcare	$3,859 - $5,323	1583%
Emi Health	$4,631	1900%

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 $2,129.
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 Holy Cross Hospital-Davis 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.