MRI, lower back (no contrast)
Facility: Hamilton County Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,298
- Cash Discount Price: $1,443
- vs. Medicare Baseline: 5.32x 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 532% of the Medicare baseline (a markup of 432%). 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 | $247 - $553 | 101% |
| First Health Coventry - All Plans | $1,226 | 503% |
| UnitedHealthcare | $1,370 | 562% |
| Cigna | $1,370 | 562% |
| Va Ccn - All Plans | $1,442 | 592% |
| Aetna | $2,452 | 1006% |
Consumer Guidance & Cost Commentary
For the MRI of the lower back (no contrast) at Hamilton County Hospital in Syracuse, KS, the cash price is $1,443, which matches the facility's median negotiated rate of $1,370. This cash price is 5.3% higher than the Medicare benchmark of $243.77, indicating a significant markup relative to the federal cost baseline. While the facility is a Critical Access Hospital with government local ownership, patients should note that commercial insurance plans like Aetna and UnitedHealthcare have negotiated rates ranging from $1,226 to $2,452, which are often higher than the cash price due to administrative overhead and contract structures. If you have a high-deductible plan, paying the cash price directly might be more cost-effective than relying on insurance, especially since the negotiated rates for some payers exceed the cash amount.
To ensure you are receiving the best possible price, it is crucial to request an itemized billing audit before finalizing payment, as summary bills often obscure individual charges and potential errors. Since over 80% of hospital bills contain mistakes such as unbundled codes or services not rendered, asking for a line-by-line CPT-coded statement can help identify and correct these issues. Additionally, you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if you pay in full upfront. Avoid assuming that being in-network guarantees the lowest rate, as different insurers negotiate varying amounts; always verify the specific allowed amount for your plan before scheduling the procedure.