CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Charleston Area Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $3,662
Cash Discount Price: $4,380
vs. Medicare Baseline: 15.02x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Charleston Area Medical Center is $3,662. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,380. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 15.02x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$4,380

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,662

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: $4,380 (1797%)

Insurance Median: $3,662 (1502%)

Cash: $4,380 (1797% of Medicare)

Ins. Median: $3,662 (1502% 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 1502% of the Medicare baseline (a markup of 1402%). 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
Aetna	$96 - $4,658	39%
The Health Plan Of West Virginia Inc.	$96 - $4,610	39%
Unicare Health Plan Of West Virginia Inc.	$96	39%
Triwest Va	$236	97%
Blue Cross Blue Shield	$244 - $4,334	100%
Choicecare Network	$244 - $4,658	100%
Optimum Choice Inc.	$244	100%
UnitedHealthcare	$251 - $4,658	103%
West Virginia Senior Advantage Inc.	$256	105%
Integrated Medical Solutions	$475	195%
Naphcare	$488	200%
Caresource	$609	250%
Tricare	$2,265 - $2,852	929%
City Of Charleston	$2,831 - $3,565	1161%
Cigna	$3,511 - $4,420	1440%
Three Rivers Providers Network	$3,662 - $4,610	1502%
Healthsmart	$3,700 - $4,658	1518%
Multiplan	$3,700 - $4,658	1518%

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 $4,380.
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 Charleston Area Medical Center 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.