MRI, lower back (no contrast)
Facility: Nmc Health
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,394
- Cash Discount Price: $1,696
- vs. Medicare Baseline: 5.72x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 572% of the Medicare baseline (a markup of 472%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Bluestem Pace | $225 | 92% |
| Leading Age | $361 | 148% |
| Medicaid / KanCare | $361 | 148% |
| Blue Cross Blue Shield | $553 | 227% |
| Aetna | $811 | 333% |
| Wppa | $1,333 | 547% |
| Occunet | $1,454 | 596% |
| Samaritan Ministries International | $1,575 | 646% |
| Medincrease Health Plan | $1,575 | 646% |
| Prime Health Services | $1,817 | 745% |
| UnitedHealthcare | $2,181 | 895% |
| Cigna | $2,302 | 944% |
Consumer Guidance & Cost Commentary
For this MRI of the lower back without contrast at Nmc Health in Newton, KS, the cash price is $1,696, which is lower than the facility's gross charge of $2,423. While the facility's negotiated rates with insurance plans range from $225 to $2,302, the cash price is notably lower than the median negotiated rate of $1,394 reported for this service. Patients with high-deductible plans or those without insurance may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to verify your specific plan's allowed amount before scheduling, as some commercial payers may negotiate rates significantly higher than the cash price due to administrative costs and contract dynamics.
To ensure you are not overcharged, always request an itemized bill before paying, as summary bills can obscure individual line items and potential errors. If you receive a bill that includes charges for services not rendered or unbundled components, you should dispute it in writing rather than accepting the summary total. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the final amount if you settle the bill upfront, bypassing the higher administrative fees associated with insurance claims. Finally, remember that Medicare rates serve as a reliable benchmark for fair pricing; in this case, the Medicare amount is $243.77, providing a clear baseline to evaluate whether the facility's commercial rates are reasonable or inflated.