MRI, lower back (no contrast)
Facility: Kiowa District Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $898
- Cash Discount Price: $760
- vs. Medicare Baseline: 3.68x 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 368% of the Medicare baseline (a markup of 268%). 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 |
|---|---|---|
| Tricare | $370 | 152% |
| Blue Cross Blue Shield | $521 | 214% |
| Healthchoice-All Plans | $583 | 239% |
| UnitedHealthcare | $760 - $950 | 312% |
| Health Partners Of Ks-All Plans | $836 | 343% |
| Humana | $857 | 352% |
| Gbs Insurance - All Plans | $893 | 366% |
| Multiplan-All Plans | $893 | 366% |
| Aetna | $902 | 370% |
| Triwest-All Plans | $902 | 370% |
| Medicare (plans) | $902 | 370% |
| Medicaid / KanCare | $950 | 390% |
| Providers Care (Wppa)-All Plans | $1,425 | 585% |
| Liberty Healthshare-All Plans | $1,534 | 629% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Kiowa District Hospital, the cash price is $760, which is significantly lower than the median negotiated rates of $893 to $898 paid by most insurance plans. While the facility's cash rate is higher than the Medicare benchmark of $243.77, it remains the most affordable option for patients without insurance or those with high-deductible plans where the insurance allowed amount might exceed the cash price. The facility is a Critical Access Hospital in Kiowa, Kansas, and while specific county or state average data is not provided in this report, patients should be aware that commercial negotiated rates often include administrative overhead that can inflate the final cost compared to direct payment.
Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as paying the full bill upfront can sometimes reduce the amount owed by 20% to 50%. It is important to note that even though this facility is in-network for many carriers, the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, though unexpected ancillary charges could still occur. To ensure you are receiving the most accurate pricing, always request an itemized bill before paying and verify your deductible status, as paying the negotiated rate without meeting your deductible may result in higher out-of-pocket costs than paying the cash price directly.