MRI, lower back (no contrast)
Facility: Smith County Memorial Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $917
- Cash Discount Price: $975
- vs. Medicare Baseline: 3.76x 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 376% of the Medicare baseline (a markup of 276%). 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 | $521 | 214% |
| Medicaid / KanCare | $682 - $975 | 280% |
| Multiplan-All Plans | $878 | 360% |
| Wppa-All Plans | $916 | 376% |
| Health Partners Of Ks Ppo-All Plans | $926 | 380% |
| Midlands Choice-All Plans | $926 | 380% |
| UnitedHealthcare | $926 | 380% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Smith County Memorial Hospital in Smith Center, KS, the cash price is $975.00, which matches the facility's gross charge and the median cash rate. This cash price is significantly higher than the Medicare benchmark of $243.77, indicating a markup of 3.8 times the federal rate. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans might find paying the full cash price upfront more cost-effective than relying on insurance, as the negotiated rates for in-network payers like Medicaid/KanCare and UnitedHealthcare range from $878 to $975, often exceeding the cash amount. It is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid in full within a short window, bypassing the administrative costs associated with insurance claims processing.
Insurance coverage varies widely depending on the payer; for instance, Blue Cross Blue Shield has a single plan paying $521, while Medicaid/KanCare covers three plans with negotiated rates between $682 and $975. Because commercial negotiated rates often include administrative overhead and do not reflect the true cost of care, patients should verify their specific plan's allowed amount before scheduling to avoid balance billing surprises. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to review all registration paperwork carefully and refuse to sign any waivers that might inadvertently allow for out-of-network cost sharing on mandatory ancillary services. If a discrepancy arises between the expected payment