MRI, lower back (no contrast)
Facility: Saint John Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $238
- Cash Discount Price: $224
- vs. Medicare Baseline: 0.98x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $131 | 54% |
| Comp Alliance Workers Comp | $221 | 91% |
| Medicare (plans) | $225 | 92% |
| Midland Care Connection | $225 | 92% |
| UnitedHealthcare | $225 - $315 | 92% |
| Tricare | $225 | 92% |
| Cigna | $225 | 92% |
| Aetna | $225 - $349 | 92% |
| Kansas Superior Select | $229 | 94% |
| Healthy Blue | $236 - $238 | 97% |
| Celtic | $236 - $360 | 97% |
| Oha Networks | $238 | 98% |
| Worker Compensation | $246 | 101% |
| Blue Cross Blue Shield | $262 - $553 | 107% |
| Well Path | $315 | 129% |
| Employer Direct Healthcare | $315 | 129% |
| Corizon | $315 | 129% |
| Centurion | $337 | 138% |
| Naphcare | $348 | 143% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Saint John Hospital in Leavenworth, KS, the cash price of $224.00 is significantly lower than the negotiated rates paid by insurance plans, which range from $131 to $553 depending on the payer. While the facility's cash rate is competitive, it is important to note that many commercial payers, such as UnitedHealthcare and Celtic, have negotiated rates that exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. To maximize savings, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling; hospitals often offer a fee reduction of 20% to 50% for upfront payment, bypassing the administrative costs associated with insurance claims processing.
The facility's pricing is benchmarked against the Medicare rate of $243.77, which serves as a scientifically validated baseline for the true cost of care. Although the cash price is slightly below the Medicare amount, the gross charge of $5,342.00 represents a substantial markup. Commercial negotiated rates vary widely across the 19 participating payers, with some plans like Medicaid / KanCare and Comp Alliance Workers Comp paying the lowest amounts at $131 and $221, respectively. Patients should be aware that balance billing is generally prohibited for emergency services under the No Surprises Act, but it is crucial to verify network status and deductible coverage before receiving care to avoid unexpected out-of-pocket expenses beyond the negotiated or cash rates.