MRI, lower back (no contrast)
Facility: Kiowa County Memorial Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $890
- Cash Discount Price: $850
- vs. Medicare Baseline: 3.65x 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 365% of the Medicare baseline (a markup of 265%). 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 | $526 - $890 | 216% |
| UnitedHealthcare | $801 - $1,000 | 329% |
| Health Partners Of Ks-All Plans | $880 | 361% |
| Aetna | $890 | 365% |
| Humana | $890 | 365% |
| Celtic Comml Exchange-All Other Plans | $890 | 365% |
| Medica Prime Mcare Cost-All Plans | $890 | 365% |
| Medicaid / KanCare | $1,000 | 410% |
| Providrs Care/Wppa-All Plans | $1,500 | 615% |
Consumer Guidance & Cost Commentary
For the MRI of the lower back (no contrast) at Kiowa County Memorial Hospital in Greensburg, KS, the commercial negotiated rates range from $526 to $1,500 depending on the insurance plan, with a median negotiated amount of $890. This facility is a Critical Access Hospital owned by the local government, and while the cash price is $850, the median amount paid by insurers is $890. In this specific case, the cash price is lower than the average negotiated rate, meaning patients with high-deductible plans might save money by paying out-of-pocket or utilizing a prompt-pay discount rather than relying on insurance. It is important to note that commercial rates often include administrative overhead and contract dynamics that can inflate the baseline price, so comparing the $890 negotiated rate directly to the $850 cash price reveals that self-pay options are currently the most cost-effective choice for this service.
When evaluating the cost against federal benchmarks, the Medicare amount for this procedure is $243.77, which serves as the objective baseline for evaluating hospital pricing markups. Commercial negotiated rates typically average 200% to 300% of Medicare, while fair pricing is generally defined as 120% to 150% of this rate. Although the data does not provide specific county or state average comparisons for this exact code, the facility's location in Kansas (Zip 67054) means local wage indexes influence the Medicare benchmark used for cost-basis standards. Patients should be aware that hospitals may inflate their chargemaster lists to make discounts appear larger, so the most accurate comparison is always between the final negotiated or cash