MRI, lower back (no contrast)
Facility: Great Plains Of Sabetha
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,150
- Cash Discount Price: $1,211
- vs. Medicare Baseline: 4.72x 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 472% of the Medicare baseline (a markup of 372%). 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 |
|---|---|---|
| Celtic Mcr Adv | $630 | 258% |
| Aetna | $636 - $1,223 | 261% |
| Celtic Comm Exchange-All Other Plans | $787 | 323% |
| Great West Healthcare-All Plans | $1,029 | 422% |
| UnitedHealthcare | $1,126 - $1,211 | 462% |
| Multiplan-Phcs-All Plans | $1,150 | 472% |
| Century/Wppa/Providers-All Plans | $1,150 | 472% |
| Cigna | $1,150 | 472% |
| Humana | $1,150 | 472% |
| Federated Mutual Ins-All Plans | $1,162 | 477% |
| Medicaid / KanCare | $1,211 | 497% |
| Blue Cross Blue Shield | $1,211 | 497% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Great Plains Of Sabetha, the cash price is $1,211.00, which matches the facility's negotiated rate for Medicaid/KanCare and the gross charge. This cash price is significantly higher than the state average for this service, as indicated by the 4.7x markup relative to the Medicare benchmark of $243.77. While commercial insurance plans like Aetna and UnitedHealthcare have negotiated rates ranging from $630 to $1,223, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the full cash price upfront rather than relying on insurance reimbursement.
Patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing costly insurance claims processing. It is important to avoid accepting summary bills without requesting a detailed, itemized statement to ensure no errors or unbundled charges are included. Additionally, while the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, patients should verify their specific plan details and deductible status to avoid unexpected out-of-pocket costs, as the facility's ownership as a voluntary non-profit does not automatically guarantee lower rates for all insurance carriers.