MRI, lower back (no contrast)
Facility: Clara Barton Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,577
- Cash Discount Price: $1,226
- vs. Medicare Baseline: 6.47x 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 647% of the Medicare baseline (a markup of 547%). 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 | $521 | 214% |
| 6 Degrees Health - All Plans | $1,226 | 503% |
| Wppa-All Plans | $1,402 | 575% |
| Aetna | $1,577 | 647% |
| Phcs - All Plans | $1,577 | 647% |
| UnitedHealthcare | $1,577 | 647% |
| Hlth Partners Of Ks-All Plans | $1,612 | 661% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Clara Barton Hospital in Hoisington, KS, the facility's cash median price is $1,226, which is lower than the negotiated rates of $1,577 paid by major insurers like Aetna, UnitedHealthcare, and Blue Cross Blue Shield. While the facility's negotiated rate of $1,577 is higher than the state average for this service, patients with high-deductible plans may find paying the cash price of $1,226 more cost-effective if their insurance allowed amount exceeds this figure. It is important to note that the facility's cash rate is still significantly higher than the Medicare benchmark of $243.77, indicating a substantial markup relative to the federal government's cost-based reimbursement.
Patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs than direct cash payment due to administrative overhead and network tiering. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to verify your specific plan's allowed amount before scheduling. Additionally, you should explicitly request a "self-pay" or "prompt-pay" discount at the time of registration, as these upfront payment incentives can reduce the final bill further. If you receive a summary bill, do not accept it as final; instead, demand a full itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.