MRI, lower back (no contrast)
Facility: Phillips County Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $742
- Cash Discount Price: $697
- vs. Medicare Baseline: 3.04x 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 304% of the Medicare baseline (a markup of 204%). 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 | $553 - $664 | 227% |
| UnitedHealthcare | $656 - $820 | 269% |
| Medicaid / KanCare | $820 | 336% |
| Health Partners-All Plans | $820 | 336% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Phillips County Hospital in Phillipsburg, KS, the facility's cash median price of $697.00 is lower than the negotiated rates paid by major payers, including UnitedHealthcare's maximum of $820.00 and Blue Cross Blue Shield's range of $553.00 to $664.00. This pricing structure highlights that cash-pay options can sometimes be more cost-effective for patients with high-deductible plans, as the cash median is significantly lower than the median negotiated rate of $742.00. Since Medicaid/KanCare and Health Partners-All Plans also pay the full gross amount of $820.00, patients with these specific plans may find the cash price of $697.00 offers the most direct savings.
To minimize unexpected costs, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the bill by bypassing administrative processing fees. It is important to note that while the facility is a Critical Access Hospital owned by the local government, the gross charge of $820.00 serves as the baseline; commercial insurance contracts cap payments at negotiated rates that often exceed the cash price due to administrative overhead. Consumers are advised to request an itemized bill to ensure no unbundled codes or services not rendered are included, and to dispute any balance billing immediately if it occurs, as federal protections like the No Surprises Act may apply depending on the specific network status of ancillary services.