MRI, lower back (no contrast)
Facility: Graham County Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $601
- Cash Discount Price: $775
- vs. Medicare Baseline: 2.47x 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 247% of the Medicare baseline (a markup of 147%). 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 | $374 - $736 | 153% |
| Medicaid / KanCare | $374 | 153% |
| Blue Cross Blue Shield | $521 | 214% |
| Medicare (plans) | $581 | 238% |
| Celtic Commercial-All Other Plans | $639 | 262% |
| Wppa (Providers Care)-All Plans | $736 | 302% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Graham County Hospital in Hill City, KS, the cash price is $775.00, which matches the facility's median paid amount. This cash rate is significantly higher than the Medicare benchmark of $243.77, reflecting a markup of 2.5 times the federal reimbursement rate. While commercial payers negotiate rates ranging from $374 to $736 depending on the plan, patients with high-deductible plans may find the cash price more affordable if their insurance negotiated rate exceeds $775.00. It is important to note that the facility is a Critical Access Hospital owned by the local government, and patients should verify their specific plan's allowed amount before scheduling to avoid unexpected costs.
To ensure you are receiving the most accurate pricing, always request an itemized bill that lists every CPT code and unit cost rather than accepting a summary invoice that obscures individual charges. If you choose to pay out-of-pocket, ask the billing department about prompt-pay discounts, which can reduce the total by 20% to 50% if settled within 30 days. Additionally, be aware that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, you should still review your statement for any unbundled codes or services not rendered. Comparing this facility's rates to state and county averages provides context, but the most effective way to manage medical debt is to dispute any errors on your itemized statement in writing before making a payment.