CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Gundersen Moundview Hospital and Clinics

Billing Code: 72148 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$467

about 1.9× the $244 Medicare rate · typically $152–$2,623

modeled estimate · not a bill or quote

Medicare pays $244 Fair price $467 Cash price $2,053 Hospital's list price $4,002

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$1,591	653%
Blue Cross Blue Shieldmajor	$740 - $3,696	304%
Aetnamajor	$3,802	1560%
Humanamajor	$3,402	1396%
Amerigroup	$103	42%
Dean Health Plan	$1,193	489%
HealthPartners	$1,841 - $3,534	755%
Quartz	$2,181	895%
Security Health Plan	$1,841	755%
UCare	$1,841 - $3,202	755%
+ 5 smaller / regional plans	$740 - $3,802

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 2,053), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72148.

Insurance Before you use insurance

Call your insurance company to confirm Gundersen Moundview Hospital and Clinics is in-network.
Ask your insurer whether prior approval is required for CPT code 72148.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Gundersen Moundview Hospital and Clinics

Compare: MRI, lower back (no contrast) at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.