MRI, lower back (no contrast)
Facility: Kansas City Orthopaedic Institute
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $750
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.08x 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 308% of the Medicare baseline (a markup of 208%). 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 |
|---|---|---|
| UnitedHealthcare | $217 - $1,390 | 89% |
| Aetna | $217 | 89% |
| Cigna | $227 - $1,016 | 93% |
| Blue Cross Blue Shield | $750 - $1,300 | 308% |
| Medica | $1,190 | 488% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Kansas City Orthopaedic Institute in Leawood, KS, the Medicare benchmark rate is $243.77. This federally calculated baseline represents the true cost of delivering this service and serves as the most reliable standard for evaluating pricing markups. While the facility's negotiated rates with major payers like UnitedHealthcare and Cigna range from $217 to $1,390, these amounts are significantly higher than the Medicare rate, reflecting the typical administrative overhead and contract dynamics inherent in commercial insurance billing. It is important to note that cash-pay options are not listed for this specific code, meaning patients without insurance coverage would not be able to utilize the potential savings of paying directly out-of-pocket.
Patients should be aware that commercial negotiated rates often include multi-layered administrative costs and do not necessarily represent the lowest possible price. Since this facility is an Acute Care Hospital owned by physicians, patients with high-deductible plans might find that the cash price is lower than their insurance allowed amount, though no cash rate is currently available for this code. To minimize costs, individuals should contact the billing department directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid upfront. Additionally, if you have received a bill, request a full itemized statement to verify that all charges are accurate and that no services were unbundled or double-billed, as over 80% of hospital bills contain errors that can be corrected through a formal audit.