MRI, lower back (no contrast)
Facility: Osborne County Memorial Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,235
- Cash Discount Price: $1,159
- vs. Medicare Baseline: 5.07x 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 507% of the Medicare baseline (a markup of 407%). 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 |
|---|---|---|
| UnitedHealthcare | $1,037 | 425% |
| Health Partners Of Kansas | $1,173 | 481% |
| Wppa | $1,296 | 532% |
| Blue Cross Blue Shield | $1,337 | 548% |
Consumer Guidance & Cost Commentary
For patients paying cash directly, the most important thing to know is that this specific MRI procedure carries a median cash rate of $1,159, which is significantly lower than the facility's gross charge of $1,364. While the facility is a government-owned Critical Access Hospital in Osborne County, Kansas, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as paying upfront can sometimes bypass administrative fees and reduce the final amount owed. It is also worth noting that for individuals with high-deductible plans, paying the cash rate of $1,159 may be more cost-effective than using insurance, since the negotiated rates for in-network payers range from $1,037 to $1,337, depending on the specific carrier.
When viewed against broader market standards, the cash rate of $1,159 remains substantially lower than the facility's gross charge, illustrating the potential savings found in direct payment scenarios. However, the negotiated rates for commercial payers sit closer to the gross charge, with the highest allowed amount reaching $1,337 under Blue Cross Blue Shield and the lowest at $1,037 under UnitedHealthcare. These commercial rates are notably higher than the Medicare amount of $243.77, reflecting the typical markup structure where commercial contracts often exceed 200% of the Medicare benchmark. Consumers should be aware that while Medicare serves as the objective baseline for cost, commercial rates include additional layers for claims processing and contract management, making the cash option a strategic choice for those who qualify for self-pay pricing.