MRI, lower back (no contrast)
Facility: Sheridan County Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $761
- Cash Discount Price: $854
- vs. Medicare Baseline: 3.12x 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 312% of the Medicare baseline (a markup of 212%). 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 Insurance | $517 | 212% |
| Blue Cross Blue Shield | $761 | 312% |
| UnitedHealthcare | $811 | 333% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Sheridan County Hospital in Hoxie, KS, the cash price is $854.00, which matches the facility's median negotiated rate of $761.00 and the cash median. This cash price is significantly higher than the Medicare benchmark of $243.77, reflecting a markup of 3.1 times the federal rate. While the facility is a Critical Access Hospital owned by the local government, patients should note that commercial insurance rates often exceed cash prices due to administrative overhead and contract structures. In this case, the negotiated rates for payers like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare range from $517 to $811, meaning that for patients with high-deductible plans, paying the cash price directly could result in lower out-of-pocket costs compared to using insurance if their deductible has not yet been met.
To minimize costs, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce bills by 20% to 50% by bypassing insurance claims processing fees. It is also important to avoid accepting summary bills without reviewing an itemized statement, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be disputed in writing. Since the facility is in-network, the No Surprises Act generally protects patients from balance billing for out-of-network services at this location, but patients must verify their specific plan details to ensure they are not subject to unexpected charges. Always confirm your deductible status and ask for a written waiver of insurance submission if you intend to pay cash upfront to secure