MRI, lower back (no contrast)
Facility: Nemaha Valley Community Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $998
- Cash Discount Price: $1,790
- vs. Medicare Baseline: 4.09x 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 409% of the Medicare baseline (a markup of 309%). 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% |
| Va Ccn - All Plans | $875 | 359% |
| Humana | $875 | 359% |
| Aetna | $884 - $1,690 | 363% |
| Celtic Comm Exch - All Plans | $963 | 395% |
| Partners Direct Health - All Plans | $1,034 | 424% |
| Multiplan - All Plans | $1,790 | 734% |
| Midlands Choice - All Plans | $1,889 | 775% |
| Health Partners - All Plans | $1,889 | 775% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash price of $1,790 is significantly higher than the state average, which is $243.77. While the hospital offers a negotiated rate of $998 for in-network patients, this amount remains well above the Medicare benchmark of $243.77, indicating a substantial markup relative to the federal baseline. Patients with high-deductible plans should consider that paying the cash price of $1,790 upfront might be more cost-effective than using insurance, as the negotiated rate often exceeds the cash price due to administrative overhead and contract dynamics. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final cost.
The data shows that while most payers have a single agreed-upon rate, Aetna has two plans with a range between $884 and $1,690, and the median negotiated payment across all plans is $1,034. This variation highlights the importance of verifying your specific plan's allowed amount before scheduling, as in-network status does not guarantee the lowest possible price. To ensure you are not overcharged, request a detailed, itemized bill that breaks down every CPT code and charge, as summary bills often obscure errors or unbundled services. If you receive a balance bill for out-of-network services, remember that the No Surprises Act protects you from paying the difference for emergency care and non-emergency services at in-network facilities, and you should dispute any such bills in writing with your