CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Vandalia Health Broaddus Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,644
Cash Discount Price: $1,571
vs. Medicare Baseline: 6.74x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Vandalia Health Broaddus Hospital is $1,644. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,571. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.74x the Medicare baseline. Located in 1 Healthcare Drive Mansfield Hill, Philippi, WV.

Cash / Self-Pay

$1,571

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,644

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: $1,571 (644%)

Insurance Median: $1,644 (674%)

Cash: $1,571 (644% of Medicare)

Ins. Median: $1,644 (674% 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 674% of the Medicare baseline (a markup of 574%). 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
Correctional Medical Systems	$50 - $131	21%
Aetna	$53 - $2,006	22%
The Health Plan	$53 - $2,020	22%
Unicare	$53 - $138	22%
Blue Cross Blue Shield	$128 - $1,592	53%
Peak Health	$387 - $715	159%
Highmark	$1,644	674%
UnitedHealthcare	$1,661 - $2,179	681%
Humana	$1,727	708%
West Virginia Senior Advantage	$1,744	715%
Cigna	$1,964	806%
First Health	$2,006	823%
Geisenger Health Plan	$2,087	856%
Health Network America	$2,087 - $2,132	856%
Multiplan/Phcs	$2,109	865%
Geha	$2,132	875%
Selectnet	$2,199	902%

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 $1,571.
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 Vandalia Health Broaddus 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.