CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Bellin Health Oconto Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $927
Cash Discount Price: $787
vs. Medicare Baseline: 3.80x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Bellin Health Oconto Hospital is $927. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $787. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.80x the Medicare baseline. Located in 820 Arbutus Ave, Oconto, WI.

Cash / Self-Pay

$787

Average discount available for prompt cash payment at this facility.

Insurance Median

$927

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: $787 (323%)

Insurance Median: $927 (380%)

Cash: $787 (323% of Medicare)

Ins. Median: $927 (380% 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 380% of the Medicare baseline (a markup of 280%). 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
Blue Cross Blue Shield	$411 - $4,144	169%
Community Care	$411	169%
Humana	$411	169%
My Choice	$411	169%
Network Health	$411 - $1,028	169%
UnitedHealthcare	$496 - $846	203%
Aetna	$605	248%
Cigna	$855 - $870	351%
Common Ground	$881 - $905	361%
Chorus Community Health Plan	$908	372%
Aspirus Arise	$947	388%
Healthsmart	$968	397%
Ihs(Claimsbridge)	$968	397%
Medical College Of Wi	$968	397%
Hps/Paymedix	$992 - $1,077	407%
Wps Insurance	$1,016	417%
Allied National	$1,028	422%
First Health	$1,028	422%
Galaxy Health	$1,028	422%
Three Rivers Provider Network	$1,089	447%
Trilogy	$1,089	447%

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 $787.
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 Bellin Health Oconto 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.