CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Margaretville Memorial Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,399
Cash Discount Price: $3,072
vs. Medicare Baseline: 5.74x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Margaretville Memorial Hospital is $1,399. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,072. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.74x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$3,072

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,399

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: $3,072 (1260%)

Insurance Median: $1,399 (574%)

Cash: $3,072 (1260% of Medicare)

Ins. Median: $1,399 (574% 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 574% of the Medicare baseline (a markup of 474%). 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
Oxford	$373	153%
UnitedHealthcare	$373 - $1,352	153%
Aetna	$383 - $3,072	157%
Mvp	$530	217%
Emblem	$549 - $646	225%
Blue Cross Blue Shield	$1,352 - $2,440	555%
Hamaspik (McR)	$1,352	555%
Medicare (plans)	$1,352 - $2,028	555%
Mvp Gold (McR)	$1,352	555%
Affinity By Molina McR	$1,419	582%
Cdphp	$1,487	610%
Mvp Exchange	$1,629	668%
Emblem Ghi/Hip Ppo/Cbp	$1,905	781%
Mvp Hmo/Ppo	$1,917	786%
Emblem Select Care (Exchange)	$2,089	857%
Magnacare Standard	$2,150	882%
Oxford Exchange	$2,150	882%
Todays Options	$2,230	915%
Emblem Ghi/Hip Hmo/Epo/Pos	$2,458	1008%
Magnacare Preferred	$2,458	1008%
Multiplan	$2,519	1033%
Self-Pay	$2,632	1080%
First Health	$2,765	1134%

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 $3,072.
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 Margaretville 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.