CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Prosser Memorial Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $150
Cash Discount Price: $1,151
vs. Medicare Baseline: 0.62x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Prosser Memorial Hospital is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,151. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.62x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$1,151

Average discount available for prompt cash payment at this facility.

Insurance Median

$150

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: $1,151 (472%)

Insurance Median: $150 (62%)

Cash: $1,151 (472% of Medicare)

Ins. Median: $150 (62% 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.

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
Community Health Plan Of Washington	$40 - $1,573	16%
Coordinated Care	$40 - $1,573	16%
Kaiser Permanente	$40 - $3,535	16%
UnitedHealthcare	$40 - $1,590	16%
Amerigroup	$42 - $1,668	17%
Molina	$42 - $1,573	17%
Health Alliance Northwest	$78 - $971	32%
Humana	$78 - $3,302	32%
Wellcare	$78 - $971	32%
Aetna	$79 - $3,302	32%
Cigna	$88 - $3,186	36%
Premera	$95 - $3,108	39%
Asuris	$106 - $3,496	43%
Health Management Adminstrators	$106 - $3,496	43%
Regence	$106 - $3,496	43%
Ambetter / Centene	$141 - $2,991	58%
Multiplan	$255 - $3,496	105%
First Choice	$3,302	1355%

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 $1,151.
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 Prosser Memorial 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.