MRI, lower back (no contrast)
Facility: Kansas Surgery & Recovery Center
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $223
- Cash Discount Price: $792
- vs. Medicare Baseline: 0.91x 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 |
|---|---|---|
| Aetna | $207 - $831 | 85% |
| Blue Cross Blue Shield | $207 - $527 | 85% |
| UnitedHealthcare | $223 - $1,044 | 91% |
| Cigna | $549 | 225% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Kansas Surgery & Recovery Center in Wichita, KS, the cash price of $792.00 is significantly lower than the negotiated rates charged by major insurers like Aetna, Blue Cross Blue Shield, and UnitedHealthcare, which range from $207 to $1,044 depending on the specific plan. While the facility's cash median of $792.00 is slightly below its gross charge of $796.00, patients with high-deductible plans or those without insurance may find this self-pay option most cost-effective, as insurance allowed amounts often exceed the cash price. It is important to note that commercial negotiated rates frequently include administrative overhead and contract markups that can inflate the final cost compared to direct payment, making it a smart strategy to verify self-pay or prompt-pay discounts before scheduling to avoid unexpected balances.
The facility's pricing aligns closely with the Medicare benchmark of $243.77, with a ratio of 0.9, indicating that the cash rate is slightly higher than the federal baseline but remains competitive when compared to the wide variance in commercial payer rates. Although the data does not provide specific state or county average comparisons for this specific CPT code, the significant difference between the cash price and the highest negotiated rate (up to $1,044 for UnitedHealthcare) highlights the potential for substantial savings through direct payment. Consumers should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, it is crucial to request an itemized bill to ensure no unbundled charges or services not rendered are included, and to formally dispute any discrepancies