MRI, lower back (no contrast)
Facility: Cheyenne County Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $793
- Cash Discount Price: $710
- vs. Medicare Baseline: 3.25x 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 325% of the Medicare baseline (a markup of 225%). 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 | $479 - $835 | 196% |
| Blue Cross Blue Shield | $521 | 214% |
| First Health - All Plans | $584 | 240% |
| Tricare | $601 | 247% |
| Healthy Blue Mcr Adv | $601 | 247% |
| Aetna | $601 - $793 | 247% |
| Choice Care - All Plans | $607 | 249% |
| Firstguard - All Plans | $668 | 274% |
| Wppa - All Plans | $752 | 308% |
| Preferred Hc - All Plans | $793 | 325% |
| Cpm - All Plans | $793 | 325% |
| Midlands Choice - All Plans | $810 | 332% |
| Integrated Hp - All Plans | $818 | 336% |
| Health Partners - All Plans | $818 | 336% |
| Ppo Next - All Plans | $818 | 336% |
| Unicare - All Plans | $818 | 336% |
| Childrens Mercy - All Plans | $835 | 343% |
| Healthy Blue Mcaid - All Other Plans | $835 | 343% |
| Healthwave Mcaid - All Plans | $835 | 343% |
| Providers Care-All Plans | $1,252 | 514% |
Consumer Guidance & Cost Commentary
For this MRI of the lower back without contrast at Cheyenne County Hospital in St. Francis, KS, the facility's cash price is $710, which is lower than the gross charge of $835. While the hospital is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should note that insurance negotiated rates vary significantly; for instance, UnitedHealthcare pays $479 to $835, while other payers like Aetna and Preferred Hc range from $601 to $793. Because commercial negotiated rates often exceed cash prices due to administrative overhead and contract dynamics, individuals with high-deductible plans may find paying the cash price of $710 more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the deductible is not met.
To ensure you are not overcharged, it is advisable to request a full itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, since the No Surprises Act prohibits balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, you should dispute any surprise bills immediately rather than paying them out of fear of credit damage. Finally, do not assume that being in-network guarantees the lowest price; always ask the hospital directly about self-pay or prompt-pay discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing the costly insurance claims processing cycle.