MRI, lower back (no contrast)
Facility: Lane County Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $875
- Cash Discount Price: $875
- vs. Medicare Baseline: 3.59x 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 359% of the Medicare baseline (a markup of 259%). 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 | $788 - $875 | 323% |
| Aetna | $788 - $831 | 323% |
| Healthy Blue Mcr Adv - All Other Plans | $875 | 359% |
| Healthy Blue Mcaid | $875 | 359% |
| Medicaid / KanCare | $875 - $962 | 359% |
| Wppa Providers-All Plans | $1,312 | 538% |
Consumer Guidance & Cost Commentary
For the MRI of the lower back (no contrast) at Lane County Hospital in Dighton, Kansas, the cash price is $875, which matches the facility's negotiated rate and the median paid amount. This service is billed under CPT code 72148, and while the facility is a Critical Access Hospital owned by a government hospital district, the cash price is notably higher than the Medicare benchmark of $243.77. In fact, the cash price represents a 3.6x markup over the Medicare rate, which serves as the objective baseline for evaluating hospital pricing. Although commercial payers like UnitedHealthcare and Aetna have negotiated rates ranging from $788 to $875, these amounts do not reflect a significant discount off the cash price; in some cases, paying cash directly may be more cost-effective for patients with high-deductible plans who have not yet met their out-of-pocket maximums.
Patients should be aware that insurance contracts often create a ceiling on what providers can charge, yet these negotiated rates can still exceed the cash price due to administrative costs and contract dynamics. Before scheduling, it is crucial to verify your specific plan's allowed amount and check with the hospital for potential "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. If you receive a bill from an out-of-network provider or encounter unexpected charges, you have protections under the No Surprises Act that may prevent balance billing for emergency or non-emergency services at in-network facilities. Always request a full, itemized CPT-coded bill rather than accepting a summary invoice, as over 80