MRI, lower back (no contrast)
Facility: Logan County Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,374
- Cash Discount Price: $500
- vs. Medicare Baseline: 5.64x 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 564% of the Medicare baseline (a markup of 464%). 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% |
| Humana | $848 | 348% |
| Health Partners - All Plans | $1,900 | 779% |
| Medicaid / KanCare | $2,000 | 820% |
Consumer Guidance & Cost Commentary
For the MRI of the lower back (no contrast) at Logan County Hospital in Oakley, Kansas, the facility's cash price is $500, which is significantly lower than the state average of $1,374. While the hospital's negotiated rates with major payers like Blue Cross Blue Shield and Humana are $553 and $848 respectively, these amounts are still higher than the cash price. This pricing structure highlights a common billing dynamic where paying out-of-pocket can result in substantial savings compared to insurance reimbursement, particularly for patients with high-deductible plans. To maximize these savings, patients should explicitly request self-pay or prompt-pay discounts before scheduling, as hospitals often offer fee reductions of 20% to 50% for upfront payments that bypass costly insurance claims processing.
It is important to note that Medicare sets a benchmark of $243.77 for this procedure, meaning the facility's cash rate of $500 represents a markup of 5.6 times the Medicare amount. Although the facility is a Critical Access Hospital owned by the local government, patients should remain vigilant regarding balance billing, especially if they have out-of-network providers or ancillary services. If a surprise bill arises, consumers are protected under the No Surprises Act and should dispute the charge rather than paying immediately. Furthermore, since over 80% of hospital bills contain errors, patients should always request a full itemized statement before agreeing to any payment plan or negotiating a final amount.