CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Mercy Hospital Pittsburg, Inc

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $238
Cash Discount Price: $2,811
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Mercy Hospital Pittsburg, Inc is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,811. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.98x the Medicare baseline. Located in 1 Mt Carmel Way, Pittsburg, KS.

Cash / Self-Pay

$2,811

Average discount available for prompt cash payment at this facility.

Insurance Median

$238

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: $2,811 (1153%)

Insurance Median: $238 (98%)

Cash: $2,811 (1153% of Medicare)

Ins. Median: $238 (98% 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.

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	$106 - $3,676	43%
Medicaid / KanCare	$106 - $235	43%
Humana	$106 - $231	43%
Blue Cross Blue Shield	$131 - $665	54%
UnitedHealthcare	$206 - $2,915	85%
Halo Hcr Inc Hospice Contracted [320432]	$231	95%
American Health Advantage Of Ks Mcr Contracted [320508]	$231	95%
Medicare (plans)	$231 - $240	95%
Mercy Hospice Okc [20252]	$231	95%
Kindful Hospice [20434]	$231	95%
Tricare	$231	95%
Pace Of The Ozarks Contracted [320518]	$231	95%
Kindful Hospice Contracted [320434]	$231	95%
Halo Hcr Inc Hospice [20432]	$231	95%
Dept Of Veteran Affairs Contracted [320106]	$231	95%
Cross Timbers Hospice [20098]	$231	95%
Elara Caring Aspire Hospice [20433]	$231	95%
Ambetter / Centene	$235	96%
Home State Health Plan Contracted [320187]	$235	96%
Providrs Care Network Contracted [320484]	$447	183%
Health Choice Contracted [320166]	$665	273%
Cigna	$912 - $935	374%
Medica Contracted [320239]	$1,101	452%
United Medical Resources Contracted [320454]	$2,915	1196%
Mercy Benefit Admin Contracted [320251]	$3,460	1419%
Imagine 360 Contracted [320494]	$3,460	1419%
Auxiant Contracted [320462]	$3,460	1419%
Ebms Contracted [320493]	$3,460	1419%
American Healthcare Alliance Contracted [320020]	$3,460	1419%
Healthlink Contracted [320179]	$3,460	1419%
Edison Health Solutions Contracted [320502]	$3,460	1419%
Yuzu Health Contracted [320521]	$3,460	1419%
Aither Health Contracted [320449]	$3,460	1419%
Reflect Health Contracted [320492]	$3,460	1419%
Workers Comp [20426]	$3,460	1419%
First Health Contracted [320128]	$3,676	1508%

Consumer Guidance & Cost Commentary

For CPT code 72148, an MRI of the lower back without contrast, the gross charge at Mercy Hospital Pittsburg, Inc. is $4,325.00. While the facility's cash median rate is $2,811.00, which is significantly lower than the negotiated rates paid by major insurers like Aetna ($106–$3,676) and UnitedHealthcare ($206–$2,915), patients should verify their specific plan's negotiated amount before scheduling. It is important to note that for individuals with high-deductible plans, paying the cash price of $2,811.00 upfront may result in lower out-of-pocket costs compared to the insurance negotiated rate, especially if the patient has not yet met their deductible. Additionally, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.

The facility's negotiated rates vary widely across payers, with some contracts ranging as high as $3,676.00, while others, such as Medicaid/KanCare and Medicare, are fixed at $231.00. To ensure you are receiving fair pricing, it is recommended to compare these rates against the Medicare benchmark of $243.77, which serves as a scientifically validated cost baseline rather than the inflated chargemaster list price. If you receive a bill that exceeds the allowed amount for your plan, you may be subject to balance billing if the service was provided by an out-of-network provider; however, the No Surprises Act protects patients from such surprise bills for emergency care and

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 $2,811.
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 Mercy Hospital Pittsburg, Inc 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.