CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Saint Luke'S South Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72148
  • Insurance Median: $1,782
  • Cash Discount Price: $3,853
  • vs. Medicare Baseline: 7.31x Medicare
The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Saint Luke'S South Hospital is $1,782. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,853. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.31x the Medicare baseline. Located in 12300 Metcalf Avenue, Overland Park, KS.
Cash / Self-Pay
$3,853

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,782

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: $3,853 (1581%)
Insurance Median: $1,782 (731%)
Cash: $3,853 (1581% of Medicare)
Ins. Median: $1,782 (731% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 731% of the Medicare baseline (a markup of 631%). 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.

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
Medicaid / KanCare $131 - $309 54%
Humana $132 - $216 54%
Aetna $191 - $6,101 78%
UnitedHealthcare $242 - $1,782 99%
Cigna $263 - $4,874 108%
Transplants-Case Rates [5750] $265 - $6,422 109%
Blue Cross Blue Shield $463 - $4,823 190%
Commercial-Contracted [8000] $1,439 - $5,195 590%
First Health [5512] $3,807 1562%

Consumer Guidance & Cost Commentary

For the MRI, lower back (no contrast) procedure at Saint Luke's South Hospital in Overland Park, Kansas, the cash median price is $3,853, which is significantly higher than the facility's negotiated rate of $1,782. While commercial payers like Aetna and Cigna have negotiated rates ranging from $191 to over $6,000, the cash price remains a key benchmark for patients with high-deductible plans who may find paying out-of-pocket cheaper than their insurance allowed amounts. It is important to note that the facility's cash rate is well above the state average, so patients should verify if their specific insurance plan has a lower negotiated rate before scheduling. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, as paying in full upfront can sometimes bypass the administrative costs associated with insurance billing cycles.

The Medicare benchmark for this service is $243.77, which serves as a critical baseline for evaluating the facility's pricing markup. The gross charge of $6,422 is substantially higher than the Medicare amount, illustrating the difference between the hospital's full list price and the federal cost basis. Because balance billing can occur when out-of-network providers bill the difference between their chargemaster and the insurance allowed amount, patients should be cautious of unexpected bills. If a surprise bill arises, consumers should dispute it in writing and request a No Surprises Act audit rather than paying immediately. Furthermore, since over 80% of hospital bills contain errors, patients should request a detailed, itemized statement to identify any unbundled codes or services not rendered before finalizing payment.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12300 Metcalf Avenue, Overland Park, KS 66213
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals