MRI, lower back (no contrast)
Facility: Rooks County Health Center
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $2,174
- Cash Discount Price: $1,812
- vs. Medicare Baseline: 8.92x 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 892% of the Medicare baseline (a markup of 792%). 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 | $553 | 227% |
| Tricare | $1,135 | 466% |
| Veterans Admin - All Plans | $1,135 | 466% |
| Celtic Mcr Adv | $1,135 | 466% |
| Celtic Comm - All Other Plans | $1,249 | 512% |
| Preferred Benefits Admin | $2,174 | 892% |
| UnitedHealthcare | $2,174 | 892% |
| Aetna | $2,174 | 892% |
| Health Partners - All Plans | $2,295 | 941% |
| Preferred Hlthcare - All Other Plans | $2,295 | 941% |
| Healthy Blue Mcaid - All Plans | $2,416 | 991% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Rooks County Health Center in Plainville, KS, the facility's cash price of $1,812 is lower than the median negotiated rate of $2,174 paid by insurers like Preferred Benefits Admin and UnitedHealthcare. This suggests that patients with high-deductible plans might save money by paying cash directly, provided they confirm the "self-pay" or "prompt-pay" discount policies with the hospital before scheduling. While the facility is a Critical Access Hospital owned by a Government Hospital District, the cash rate remains significantly higher than the Medicare benchmark of $243.77, indicating a substantial markup relative to the federal cost baseline.
The data shows that 11 different payers, including Blue Cross Blue Shield and Tricare, have negotiated rates ranging from $553 to $2,416, with the lowest allowed amount being $553. Although the facility's cash price is lower than these negotiated rates, it is important to note that commercial rates often include administrative costs and contract premiums that can inflate the final bill. Patients should be aware that balance billing is generally prohibited for emergency care under the No Surprises Act, but they must still verify their network status and request an itemized bill to ensure no unexpected charges for out-of-network ancillary services occur.