MRI, lower back (no contrast)
Facility: Girard Medical Center
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,155
- Cash Discount Price: $1,980
- vs. Medicare Baseline: 4.74x 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 474% of the Medicare baseline (a markup of 374%). 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 | $553 - $1,155 | 227% |
| Kansas Superior Select-All Plans | $1,155 | 474% |
| Humana | $1,155 | 474% |
| Aetna | $1,155 - $5,775 | 474% |
| Medicare (plans) | $1,155 | 474% |
| Ambetter / Centene | $1,155 | 474% |
| UnitedHealthcare | $1,155 - $3,135 | 474% |
| Multiplan-All Plans | $3,052 | 1252% |
| Uhhis-All Plans | $3,135 | 1286% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Girard Medical Center in Girard, KS, the facility's cash median rate is $1,980, while the median negotiated rate for in-network insurance is $1,155. This data reflects a specific CPT code for a non-contrast scan at a Critical Access Hospital, where the government-owned facility operates under a distinct pricing structure compared to private entities. While the cash price is higher than the negotiated rate, patients with high-deductible plans may find paying out-of-pocket initially more cost-effective if their insurance allows a higher allowed amount than the cash price, though the current data shows the negotiated rate is lower. It is important to note that commercial rates often include administrative overhead for claims processing, which can inflate the baseline price by 20% to 40% compared to direct cash payments, even though the specific negotiated rate here is lower than the cash median.
Patients should be aware of the potential for balance billing if they receive care from out-of-network providers, where the provider bills the difference between the full chargemaster rate and the insurance allowed amount, though the No Surprises Act protects emergency and non-emergency services at in-network facilities from such surprise bills. Additionally, since over 80% of hospital bills contain errors, patients are strongly advised to request a detailed, itemized billing audit rather than accepting summary invoices that obscure individual charges or code unbundling. Before finalizing payment, individuals should verify their deductible status to avoid paying the full negotiated rate and should explicitly ask the hospital about self-pay or prompt-pay discounts, which can range from 20% to 50% off the total bill when paid upfront,