MRI, lower back (no contrast)
Facility: Grisell Memorial Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $816
- Cash Discount Price: $889
- vs. Medicare Baseline: 3.35x 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 335% of the Medicare baseline (a markup of 235%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $495 | 203% |
| UnitedHealthcare | $696 - $936 | 286% |
| Humana | $936 | 384% |
| Medicaid / KanCare | $936 | 384% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Grisell Memorial Hospital in Ransom, Kansas, the facility's cash median price is $889.00, which is lower than the negotiated rates paid by most insurance plans. While UnitedHealthcare members face a range of $696 to $936 depending on their specific plan, and Blue Cross Blue Shield members are charged a flat $495, the cash price of $889.00 may actually be the most economical option for patients with high-deductible plans who have not yet met their coverage thresholds. Because commercial negotiated rates often include administrative overhead and contract markups, paying cash directly can sometimes result in a lower out-of-pocket cost than what insurance allows, provided the patient qualifies for the self-pay or prompt-pay discount.
The facility's negotiated rate of $816.00 is significantly higher than the Medicare benchmark of $243.77, illustrating a common markup in commercial healthcare pricing. Although the data does not provide specific county or state average comparisons for this specific code, patients should be aware that Medicare rates serve as a scientifically validated baseline for "true" cost, meaning commercial rates are often inflated relative to this standard. To avoid unexpected balance billing or errors, consumers should request a full itemized CPT-coded bill before paying, ensuring that no unbundled charges or services not rendered are included. If a surprise bill arises, patients should dispute it in writing with the billing supervisor rather than accepting summary invoices or signing away their rights to out-of-network protections.