CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Mercy Hospital of Buffalo

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $149
  • Cash Discount Price: $573
  • vs. Medicare Baseline: 0.61x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Mercy Hospital of Buffalo is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $573. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.61x the Medicare baseline. Located in 565 Abbott Road, Buffalo, NY.
Cash / Self-Pay
$573

Average discount available for prompt cash payment at this facility.

Insurance Median
$149

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: $573 (235%)
Insurance Median: $149 (61%)
Cash: $573 (235% of Medicare)
Ins. Median: $149 (61% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
UnitedHealthcare $48 - $618 20%
Blue Cross Blue Shield $55 - $1,136 23%
Medicaid / KanCare $56 - $335 23%
VA Veterans Affairs [700001] $58 - $188 24%
Univera Healthcare [100169] $59 - $233 24%
Univera Healthcare Essential [100170] $59 - $606 24%
Fidelis Essential [100163] $61 - $1,136 25%
Beacon Essential [350122] $61 - $226 25%
Independent Health Essential [100166] $62 - $335 25%
Excellus Rochester McD [350117] $62 - $335 25%
Amerigroup [350102] $62 - $335 25%
Tuscarora Nation [550120] $62 - $335 25%
Vna Option Mltc [350110] $62 - $335 25%
Crime Victims [100176] $62 - $335 25%
Ghi [100153] $65 - $179 27%
Medicare (plans) $67 - $363 27%
Aetna $68 - $198 28%
Cigna $68 - $273 28%
Meritain [100063] $68 - $188 28%
Tricare $68 - $188 28%
Champ VA [700002] $68 - $188 28%
Catholic Health Life Pace [400005] $68 - $188 28%
Covid19 Hrsa [45013] $68 - $188 28%
Seneca Nation [450119] $68 - $188 28%
Humana $68 - $198 28%
Fallon Health [450115] $68 - $188 28%
Hospice [550001] $68 - $188 28%
Magnacare [100142] $68 - $188 28%
Wellcare Fidelis Dual [450451] $70 - $198 29%
Fidelis Dual Advantage [450120] $70 - $198 29%
Independent Health [100165] $74 - $601 30%
Iha First Choice [800001] $74 - $565 30%
Wellcare [450129] $75 - $207 31%
UPMC Health Plan [100181] $81 - $554 33%
Beacon Health Options [100023] $82 - $226 34%
Fidelis Exchange [100164] $82 - $226 34%
Mvp Healthcare [100168] $92 - $264 38%
Molina Essential [100167] $140 - $1,136 57%
Federal Workers Compensation [500100] $161 - $806 66%
No Fault [114001] $161 - $806 66%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 565 Abbott Road, Buffalo, NY 14220
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals