MRI, lower back (no contrast)
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $547
- Cash Discount Price: $1,279
- vs. Medicare Baseline: 2.24x 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 224% of the Medicare baseline (a markup of 124%). 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 |
|---|---|---|
| Humana | $106 - $235 | 43% |
| Medicaid / KanCare | $106 - $432 | 43% |
| Aetna | $106 - $231 | 43% |
| Provider Partners Health Plans Contracted [320450] | $112 | 46% |
| Blue Cross Blue Shield | $131 - $564 | 54% |
| First Health Contracted [320128] | $174 | 71% |
| UnitedHealthcare | $206 - $1,820 | 85% |
| Elara Caring Aspire Hospice [20433] | $231 | 95% |
| Kindful Hospice [20434] | $231 | 95% |
| Qual Choice Contracted [320325] | $231 | 95% |
| Pace Of The Ozarks Contracted [320518] | $231 | 95% |
| Mercy Hospice Okc [20252] | $231 | 95% |
| Medicare (plans) | $231 | 95% |
| Globalhealth Contracted [320145] | $231 | 95% |
| Mercy Mgd Behavioral Health Contracted [320259] | $231 | 95% |
| Cigna | $231 - $935 | 95% |
| Tricare | $231 | 95% |
| Cherokee Nation Health Serv Contracted [320066] | $231 | 95% |
| Halo Hcr Inc Hospice [20432] | $231 | 95% |
| Kindful Hospice Contracted [320434] | $231 | 95% |
| Medical Associates Health Contracted [320444] | $231 | 95% |
| Cross Timbers Hospice [20098] | $231 | 95% |
| Halo Hcr Inc Hospice Contracted [320432] | $231 | 95% |
| Dept Of Veteran Affairs Contracted [320106] | $235 | 96% |
| Centivo Contracted [320505] | $235 | 96% |
| United Medical Resources Contracted [320454] | $276 - $558 | 113% |
| Providrs Care Network Contracted [320484] | $447 | 183% |
| Healthscope Contracted [320182] | $558 - $1,476 | 229% |
| Insurance System Inc Contracted [320465] | $558 | 229% |
| Health Systems Inc Contracted [320174] | $558 | 229% |
| Benefit Management Contracted [320052] | $558 | 229% |
| Point C Contracted [320238] | $558 - $1,476 | 229% |
| Medica Contracted [320239] | $1,101 | 452% |
| Mercy Benefit Admin Contracted [320251] | $1,165 - $1,378 | 478% |
| Show-Me Health Administrators Contracted [320483] | $1,165 | 478% |
| Ebms Contracted [320493] | $1,378 | 565% |
| Imagine 360 Contracted [320494] | $1,378 | 565% |
| Reflect Health Contracted [320492] | $1,378 | 565% |
| Edison Health Solutions Contracted [320502] | $1,378 | 565% |
| Aither Health Contracted [320449] | $1,378 | 565% |
| American Healthcare Alliance Contracted [320020] | $1,378 | 565% |
| Yuzu Health Contracted [320521] | $1,378 | 565% |
| Auxiant Contracted [320462] | $1,378 - $1,476 | 565% |
| Healthlink Contracted [320179] | $1,476 | 605% |
| Federal Medical Center Contracted [320127] | $1,476 | 605% |
| Preferred Health Plan Contracted [320522] | $1,476 | 605% |
| Compcare Of The Ozarks Contracted [320437] | $1,555 | 638% |
| Workers Comp [20426] | $1,574 | 646% |
| Private Health Care Systems Contracted [320320] | $1,820 | 747% |
| Multiplan Contracted [320270] | $1,870 | 767% |
| Multiplan [20270] | $1,870 | 767% |
Consumer Guidance & Cost Commentary
For the MRI of the lower back (no contrast) at Mercy Specialty Hospital Southeast Kansas, the facility's cash price of $1,279 is significantly higher than the state average of $224 and the Medicare benchmark of $243.77. While commercial insurance negotiated rates generally cap payments between $106 and $1,870 depending on the payer, these rates often exceed the cash price for patients with high-deductible plans. Because insurance billing involves administrative overhead that can inflate costs by 20% to 40%, paying cash upfront may result in a lower total out-of-pocket expense if your insurance allowed amount is higher than the cash rate. Patients should verify their specific plan's allowed amount before scheduling and consider requesting a self-pay or prompt-pay discount, which can reduce the bill by 20% to 50% for upfront payment.
The facility's gross charge of $1,968 represents the maximum amount billed before any discounts or insurance negotiations are applied. To avoid balance billing or unexpected charges, patients should confirm whether their insurance is in-network and request a waiver of insurance submission if they intend to pay cash directly. If you do use insurance, it is crucial to check your deductible status before the procedure, as high negotiated rates may not be covered until that threshold is met. For transparency, we recommend requesting an itemized bill that lists every CPT code and unit cost to identify any errors, unbundled charges, or services not rendered, as over 80% of hospital bills contain discrepancies that can be corrected through a formal written audit dispute.