MRI, lower back (no contrast)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $810
- Cash Discount Price: $720
- vs. Medicare Baseline: 3.32x 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 332% of the Medicare baseline (a markup of 232%). 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 | $495 - $521 | 203% |
| UnitedHealthcare | $810 - $900 | 332% |
| Providers Care (Wppa)-All Plans | $1,575 | 646% |
Consumer Guidance & Cost Commentary
For the MRI of the lower back (no contrast) at Hospital District #6 Patterson Health Center in Anthony, KS, the cash median price is $720, which is lower than the facility's negotiated rate of $810. This service is covered by three payers, with Blue Cross Blue Shield negotiating a range between $495 and $521, while UnitedHealthcare pays between $810 and $900. The Medicare benchmark for this procedure is $243.77, indicating that the cash price represents a significant markup over the federal baseline. Patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $720, as paying out-of-pocket avoids the administrative overhead and potential deductibles associated with using commercial insurance.
To ensure you receive the most accurate pricing, it is important to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. While the facility is a Critical Access Hospital owned by a government district, patients should explicitly ask about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, because the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should verify their network status and avoid signing waivers that could expose them to unexpected out-of-network charges for ancillary services like laboratory tests.