MRI, lower back (no contrast)
Facility: Hiawatha Community Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $2,255
- Cash Discount Price: $2,895
- vs. Medicare Baseline: 9.25x 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 925% of the Medicare baseline (a markup of 825%). 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 | $525 - $553 | 215% |
| UnitedHealthcare | $1,071 - $2,487 | 439% |
| Aetna | $1,071 - $2,339 | 439% |
| Humana | $1,082 | 444% |
| Ambetter / Centene | $1,285 | 527% |
| Centrus Health Direct - All Plans | $2,171 | 891% |
| Oscar - All Plans | $2,171 | 891% |
| Preferred Hlth - All Plans | $2,606 | 1069% |
| Cigna | $2,750 | 1128% |
| Wppa Providrs Care - All Plans | $2,750 | 1128% |
| Midlands Choice - All Plans | $2,808 | 1152% |
| Multiplan - All Plans | $2,808 | 1152% |
| Healthy Blue Mcaid - All Plans | $2,895 | 1188% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Hiawatha Community Hospital, the cash price is $2,895, which matches the facility's gross charge and the Medicare benchmark of $243.77. While the hospital's negotiated rates for in-network payers range from $1,071 to $2,895, the cash price remains the highest figure in this dataset, indicating that paying out-of-pocket may not be the most cost-effective option for those with high-deductible plans. Although the facility is a Critical Access Hospital in Hiawatha, KS, the data provided does not include specific county or state average comparisons for this procedure, so no direct regional benchmarking can be performed against local averages.
Patients should be aware that while the median negotiated payment across payers is $1,129, the actual amount you owe depends on your specific insurance plan's deductible and copay structure. If your insurance has not yet met your deductible, you may be responsible for the full negotiated rate, which could exceed the cash price. To potentially reduce costs, it is advisable to ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can lower the final bill. Additionally, if you receive a bill that includes charges for services you did not receive or items that should be bundled, you have the right to request a formal itemized audit to identify and correct any errors before payment.