MRI, lower back (no contrast)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $756
- Cash Discount Price: $786
- vs. Medicare Baseline: 3.10x 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 310% of the Medicare baseline (a markup of 210%). 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 |
|---|---|---|
| Humana | $453 | 186% |
| Tricare | $489 | 201% |
| Medicaid / KanCare | $574 - $925 | 235% |
| UnitedHealthcare | $574 - $925 | 235% |
| Va Ccn - All Plans | $574 | 235% |
| Aetna | $574 - $832 | 235% |
| Ambetter / Centene | $631 | 259% |
| Blue Cross Blue Shield | $756 | 310% |
| Health Partners - All Plans | $879 | 361% |
| Healthy Blue Mcaid - All Plans | $925 | 379% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Trego County Lemke Memorial Hospital, the cash median price is $786.00, which is lower than the facility's negotiated rates of $756.00 to $925.00 across various payers. While the facility is a Critical Access Hospital in Wakeeney, KS, with a government-local ownership structure, patients should note that cash payments can sometimes be more cost-effective than using insurance, particularly if your plan has a high deductible or if the insurance negotiated rate exceeds the cash price. The facility offers a cash median of $786.00, and patients are encouraged to explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling to potentially reduce the final amount owed.
When comparing pricing, it is important to understand that commercial rates often differ significantly from the Medicare benchmark of $243.77 for this service, reflecting the administrative costs and contract dynamics of private insurance. Although the data does not provide specific state or county average figures for this procedure, the facility's negotiated range spans from $453.00 to $925.00 depending on the payer, with Medicaid/KanCare and UnitedHealthcare showing the widest variance. Patients should be aware that balance billing is generally prohibited for emergency care under the No Surprises Act, but they should still request an itemized bill to verify all charges, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered.