MRI, lower back (no contrast)
Facility: Overland Park Reg Med Ctr
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,074
- Cash Discount Price: $12,992
- vs. Medicare Baseline: 4.41x 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 441% of the Medicare baseline (a markup of 341%). 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 |
|---|---|---|
| Amerigroup | $131 | 54% |
| United | $131 - $5,847 | 54% |
| Healthyblue | $134 | 55% |
| Medicaid / KanCare | $135 | 55% |
| Unicare | $136 | 56% |
| Aetna | $136 - $6,626 | 56% |
| Multiplan | $197 - $9,614 | 81% |
| Home State Health Plan | $216 | 89% |
| Corvel Corporation | $234 - $8,445 | 96% |
| Oha Network | $243 - $6,496 | 100% |
| Cigna | $272 - $404 | 112% |
| Blue Cross Blue Shield | $622 - $5,587 | 255% |
| Humana | $711 - $918 | 292% |
| Ambetter / Centene | $2,417 | 992% |
| Nhc Advantage | $2,469 | 1013% |
| Wppa Providrs Care Network | $2,598 | 1066% |
| Universal Healthcare | $4,547 | 1865% |
| Coventry | $5,223 | 2143% |
| Coventry Kc Mo | $5,327 | 2185% |
| College Park Family Care Center | $5,587 | 2292% |
| Cco, Inc. | $9,744 | 3997% |
| Triwest Health Alliance | $9,744 | 3997% |
| Focus Healthcare Mgmt, Inc | $9,744 | 3997% |
Consumer Guidance & Cost Commentary
For this MRI of the lower back (no contrast) at Overland Park Reg Med Ctr in Kansas, the cash price is $12,992.00, which matches the facility's cash median. While the facility's negotiated rates with insurance plans range from $131 to $9,744, the cash price is notably higher than the median negotiated rate of $1,074.00 found across payers. It is important to note that for patients with high-deductible plans, paying cash upfront can sometimes be more cost-effective than relying on insurance, as the insurer's allowed amount may exceed the cash price. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full before or shortly after the service.
When evaluating costs, it is crucial to compare rates against the Medicare benchmark rather than the hospital's gross charges. The Medicare amount for this procedure is $243.77, and the facility's cash price is 4.4 times the Medicare rate. This markup is typical for commercial pricing, where negotiated rates often average 200% to 300% of the Medicare rate due to administrative costs and contract dynamics. To ensure you are not overcharged, request an itemized billing audit to review every line item and confirm that no services were unbundled or double-billed, as over 80% of hospital bills contain errors. If you receive a balance bill from an out-of-network provider, you may be protected under the No Surprises Act, which prohibits balance billing for emergency care and non