MRI, lower back (no contrast)
Facility: Morris County Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,173
- Cash Discount Price: $1,805
- vs. Medicare Baseline: 4.81x 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 481% of the Medicare baseline (a markup of 381%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $264 | 108% |
| Blue Cross Blue Shield | $525 - $1,173 | 215% |
| UnitedHealthcare | $1,173 - $3,008 | 481% |
| Coventry Mcr | $1,173 | 481% |
| Va Ccn-All Plans | $1,173 | 481% |
| Choice Care Mcr Adv-All Plans | $1,173 | 481% |
| Cigna | $2,176 | 893% |
| Aetna | $2,695 | 1106% |
| Coventry Comm-All Other Plans | $2,707 | 1110% |
| Multiplan-All Plans | $2,707 | 1110% |
Consumer Guidance & Cost Commentary
For this MRI of the lower back at Morris County Hospital in Council Grove, Kansas, the cash price of $1,805 is significantly lower than the negotiated rates charged by major insurers like UnitedHealthcare and Aetna, which range from $1,173 to $2,695. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should be aware that commercial insurance contracts often include administrative overheads that inflate the final allowed amount. If you have a high-deductible plan, paying the cash price upfront might result in lower out-of-pocket costs compared to your insurance paying its negotiated rate and leaving you responsible for the remaining deductible. It is advisable to contact the hospital directly to confirm if they offer a "self-pay" or "prompt-pay" discount, which could further reduce the $1,805 cash price.
The facility's billing practices align with standard industry benchmarks, showing a Medicare rate of $243.77 and a median paid amount of $1,675. Although specific county or state average data was not provided in this report, the significant gap between the cash price and the gross chargemaster of $3,008 highlights the importance of understanding your specific insurance tier. If you receive a bill that exceeds the negotiated rate or cash price, you should request an itemized audit to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. Additionally, under the No Surprises Act, you are protected from balance billing for out-of-network services at in-network facilities, so any unexpected charges should be disputed immediately with your insurer rather than paid in full.