MRI, lower back (no contrast)
Facility: Fredonia Regional Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $752
- Cash Discount Price: $835
- vs. Medicare Baseline: 3.08x 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 308% of the Medicare baseline (a markup of 208%). 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 | $413 - $553 | 169% |
| Aetna | $426 - $752 | 175% |
| UnitedHealthcare | $426 - $752 | 175% |
| Veterans Programs - All Plans | $426 | 175% |
| Meritain-All Plans | $752 | 308% |
| Cigna | $752 | 308% |
| Reserve National-All Plans | $752 | 308% |
Consumer Guidance & Cost Commentary
For the MRI of the lower back (no contrast) at Fredonia Regional Hospital in Kansas, the cash price is $835.00, which matches the facility's median negotiated rate and the state average. This procedure is billed under CPT code 72148, and while the facility is a Critical Access Hospital owned by the local government, the cash rate is significantly higher than the Medicare benchmark of $243.77. Medicare serves as the objective baseline for pricing, representing the true cost of delivery; commercial rates are often marked up substantially above this figure. In this case, the cash price is approximately 3.1 times the Medicare amount, illustrating that the facility's list price is not the standard for comparison.
Insurance plans from Blue Cross Blue Shield, Aetna, UnitedHealthcare, and others have negotiated rates ranging from $413 to $752, with the median allowed amount being $752.00. Because the cash price of $835.00 exceeds the median negotiated rate of $752.00, patients with high-deductible plans may find paying out-of-pocket cheaper than using insurance, provided they have not yet met their deductible. It is important to verify your specific plan's deductible status before scheduling, as relying on insurance without checking your balance can result in higher out-of-pocket costs. Additionally, patients should ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the administrative overhead associated with insurance claims.