MRI, lower back (no contrast)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $691
- Cash Discount Price: $727
- vs. Medicare Baseline: 2.83x 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 283% of the Medicare baseline (a markup of 183%). 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 | $583 | 239% |
| Humana | $662 | 272% |
| Aetna | $673 - $727 | 276% |
| UnitedHealthcare | $691 | 283% |
| Hpk-All Plans | $691 | 283% |
| Medicaid / KanCare | $727 | 298% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the cash price is $727.00, which matches the facility's gross charge and the highest negotiated rate among payers. While the median negotiated rate across six payers is $691.00, patients should be aware that cash payments can sometimes be more cost-effective than insurance claims, particularly for those with high-deductible plans where the insurer's allowed amount might exceed the cash price. Although the data does not provide specific state or county average comparisons for this CPT code, the facility is a Critical Access Hospital owned by a Government Hospital District, which often influences pricing structures. Patients are encouraged to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.
It is important to distinguish between the facility's gross charge and the actual amount your insurance will pay, as balance billing could occur if you are treated by an out-of-network provider or if ancillary services like labs are not covered under your plan. Under the No Surprises Act, balance billing for emergency care and non-emergency services at in-network facilities is prohibited, but patients should still verify their network status before scheduling to avoid unexpected costs. If you receive a bill, you have the right to request a detailed, itemized statement to identify any errors, such as unbundled codes or services not rendered, as over 80% of hospital bills contain inaccuracies that can be disputed in writing. By comparing the facility's rates against the Medicare benchmark of $