CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Preston Memorial Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,682
Cash Discount Price: $1,843
vs. Medicare Baseline: 11.00x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Preston Memorial Hospital is $2,682. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,843. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.00x the Medicare baseline. Located in 150 Memorial Drive, Kingwood, WV.

Cash / Self-Pay

$1,843

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,682

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: $1,843 (756%)

Insurance Median: $2,682 (1100%)

Cash: $1,843 (756% of Medicare)

Ins. Median: $2,682 (1100% 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 1100% of the Medicare baseline (a markup of 1000%). 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
Unicare	$103	42%
Advantra	$2,212	907%
Aetna	$2,212 - $3,318	907%
Humana	$2,212	907%
Medicare (plans)	$2,212 - $2,986	907%
Uhc_Va	$2,212	907%
Upmc	$2,322	953%
Medicaid / KanCare	$2,396 - $2,516	983%
Blue_Cross_Highmark_Aca	$2,682	1100%
Blue_Cross_Highmark_Pos	$2,976	1221%
Blue_Cross_Highmark_Ppo	$2,976	1221%
Blue_Cross_Highmark_Traditional	$3,266	1340%
UnitedHealthcare	$3,318	1361%
Cigna	$3,391	1391%
Geha	$3,502	1437%
4_Most	$3,576	1467%
Health	$3,576	1467%

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 $1,843.
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 Preston 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.