MRI, lower back (no contrast)
Facility: Minneola District Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $912
- Cash Discount Price: $481
- vs. Medicare Baseline: 3.74x 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 374% of the Medicare baseline (a markup of 274%). 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 | $65 - $804 | 27% |
| Va Community Care Program-All Plans | $65 - $804 | 27% |
| UnitedHealthcare | $65 - $1,200 | 27% |
| Aetna | $186 - $1,200 | 76% |
| Providrs Care Network-All Plans | $186 - $1,020 | 76% |
| Medicaid / KanCare | $186 - $1,200 | 76% |
| Blue Cross Blue Shield | $526 | 216% |
| Corporate Plan Management-All Plans | $1,020 | 418% |
| Preferred Health Care (Coventry)-All Other Plans | $1,080 | 443% |
| Triwest-All Plans | $1,080 | 443% |
| Phc (Coventry) Leased Network | $1,140 | 468% |
| Health Partners Of Kansas-All Plans | $1,140 | 468% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Minneola District Hospital, the cash price of $481.00 is significantly lower than the facility's negotiated rates, which range from $65 to $1,200 depending on the insurance plan. While the facility's cash price is below the state average for this service, patients with high-deductible plans may find that paying the cash price upfront is more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that the facility is a Critical Access Hospital owned by a government hospital district, and while the cash price is competitive, the negotiated rates for in-network payers like UnitedHealthcare and Aetna can reach up to $1,200, highlighting the potential cost difference between self-pay and insured billing.
To minimize costs, patients should proactively request a "self-pay" or "prompt-pay" discount before scheduling their appointment, as these upfront payment incentives can reduce the final bill by 20% to 50%. Additionally, because over 80% of hospital bills contain errors, patients should always request a detailed, itemized bill rather than accepting a summary invoice, which may hide unbundled codes or services not rendered. When reviewing the final statement, compare the allowed amount to the Medicare benchmark of $243.77; if the negotiated rate is substantially higher, it may indicate an opportunity to negotiate a lower rate or dispute the charge, ensuring you are not paying more than the true cost of care.