CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Lmh

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $240
  • Cash Discount Price: $1,116
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Lmh is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,116. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.98x the Medicare baseline. Located in 325 Maine Street, Lawrence, KS.
Cash / Self-Pay
$1,116

Average discount available for prompt cash payment at this facility.

Insurance Median
$240

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: $1,116 (458%)
Insurance Median: $240 (98%)
Cash: $1,116 (458% of Medicare)
Ins. Median: $240 (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.

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
Cigna $90 - $2,981 37%
Medicare (plans) $90 - $240 37%
Humana $90 - $240 37%
UnitedHealthcare $90 - $2,963 37%
Haskell Indian Health Services $105 - $240 43%
Blue Cross Blue Shield $105 - $2,887 43%
Allwell $107 - $245 44%
Ambetter / Centene $107 - $372 44%
Aetna $1,721 - $3,703 706%
Non Contracted $3,570 1464%
First Health $4,150 1702%

Consumer Guidance & Cost Commentary

For this MRI of the lower back (no contrast) at Lmh in Lawrence, KS, the cash price is $1,116, which is significantly lower than the facility's gross charge of $4,462. While the facility is government-owned and holds a 4-star rating, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare's range spans from $90 to $2,963, and Aetna's range is $1,721 to $3,703, both of which can be higher than the cash rate. If you have a high-deductible plan, paying the cash price upfront may result in immediate savings compared to the negotiated rates your insurer would pay, provided you have not yet met your deductible.

To ensure you are receiving the best possible rate, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if you settle the bill in full within 30 days. While the facility's negotiated average is $240, this figure likely reflects specific plan tiers or self-pay classifications rather than the standard commercial allowed amount for all members. Always verify your specific plan's allowed amount and confirm whether you qualify for self-pay discounts prior to scheduling your appointment.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 325 Maine Street, Lawrence, KS 66044
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals