MRI, lower back (no contrast)
Facility: Wichita County Health Center
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,048
- Cash Discount Price: $918
- vs. Medicare Baseline: 4.30x 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 430% of the Medicare baseline (a markup of 330%). 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 |
|---|---|---|
| Medicaid / KanCare | $947 | 388% |
| UnitedHealthcare | $1,148 | 471% |
Consumer Guidance & Cost Commentary
For the MRI of the lower back (no contrast) at Wichita County Health Center in Leoti, Kansas, the facility's cash price is $918.00, which is lower than the state average of $947.00. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans might find paying the cash price directly more affordable than using insurance, as the negotiated rate for UnitedHealthcare is $1,148.00. This scenario highlights how commercial insurance rates can sometimes exceed cash prices due to administrative costs and contract structures. To potentially lower your out-of-pocket costs, it is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can offer significant fee reductions for upfront payment.
When using insurance, be aware that the facility's negotiated rate of $1,148.00 is significantly higher than the Medicare benchmark of $243.77, illustrating the markup often found in commercial contracts. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to request a full, itemized bill before paying to ensure no errors or unbundled charges are included. Since over 80% of hospital bills contain mistakes, patients should dispute any discrepancies in writing rather than accepting summary invoices. By comparing the facility's rates against the Medicare baseline and actively seeking cash discounts, consumers can make informed decisions that align with their financial situation.