MRI, lower back (no contrast)
Facility: Hodgeman County Health Center
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,580
- Cash Discount Price: $1,796
- vs. Medicare Baseline: 6.48x 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 648% of the Medicare baseline (a markup of 548%). 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 | $500 - $526 | 205% |
| Humana | $1,437 | 589% |
| Medicaid / KanCare | $1,437 - $2,245 | 589% |
| Triwest - All Plans | $1,437 | 589% |
| UnitedHealthcare | $1,437 - $2,133 | 589% |
| Aetna | $1,796 | 737% |
| First Health - All Plans | $2,020 | 829% |
| Health Partners - All Plans | $2,133 | 875% |
| Wppa (Provdrscare) - All Plans | $2,133 | 875% |
Consumer Guidance & Cost Commentary
For the MRI of the lower back (no contrast) at Hodgeman County Health Center in Jetmore, Kansas, the cash price is $1,796, which matches the facility's median negotiated rate for Aetna. This cash rate is significantly lower than the gross charge of $2,245 and sits below the state average for this procedure. While commercial insurance plans like Humana and UnitedHealthcare negotiate rates ranging from $1,437 to $2,133, patients with high-deductible plans may find paying the cash price upfront more cost-effective, as the cash rate is often lower than the insurer's allowed amount. It is important to verify your specific plan's deductible status before scheduling, as paying out-of-pocket might result in a lower total out-of-pocket cost if your insurance has not yet covered the service.
Patients should be aware that commercial negotiated rates can sometimes exceed cash prices due to administrative costs and contract structures, making the cash option a potential savings strategy. If you choose to use insurance, ensure you request a full itemized bill before paying, as summary bills can obscure errors or unbundled charges that should be reviewed. Additionally, ask the facility about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed. Since this facility is a Critical Access Hospital with government ownership, comparing the $1,796 cash rate to the Medicare benchmark of $243.77 reveals a substantial markup, highlighting the importance of understanding the difference between the government's cost-based rate and commercial pricing.