MRI, lower back (no contrast)
Facility: Clay County Medical Center
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $144
- Cash Discount Price: $1,566
- vs. Medicare Baseline: 0.59x 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.
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 |
|---|---|---|
| Multiplan- All Plans | $69 - $2,831 | 28% |
| Health Partners - All Plans | $75 - $2,831 | 31% |
| UnitedHealthcare | $88 - $2,831 | 36% |
| Aetna | $141 - $2,771 | 58% |
| Wppa/Providrs Care- All Plans | $141 - $2,771 | 58% |
Consumer Guidance & Cost Commentary
For the MRI of the lower back (no contrast) at Clay County Medical Center in Clay Center, KS, the cash median price is $1,566, which matches the facility's gross charge. This rate is significantly higher than the state average for this procedure, as the state median paid amount is $596. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For individuals with high-deductible plans, paying the cash price of $1,566 upfront may result in lower out-of-pocket costs compared to insurance reimbursement, provided the negotiated rate from their specific plan exceeds this amount.
The Medicare benchmark for this service is $243.77, which serves as the objective baseline for evaluating pricing markups. Commercial rates, including the facility's cash price and the median negotiated rate of $144, are substantially higher than this benchmark, reflecting the standard markup found in the healthcare system. To minimize costs, patients should verify their specific plan's deductible status before scheduling, as paying out-of-pocket might be more efficient if the insurance allowed amount is high. Additionally, asking the hospital about "self-pay" or "prompt-pay" discounts prior to check-in can help secure a fee reduction, as these incentives are designed to bypass costly insurance billing cycles and provide immediate liquidity to the facility.