MRI, lower back (no contrast)
Facility: Memorial Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,421
- Cash Discount Price: $2,642
- vs. Medicare Baseline: 5.83x 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 583% of the Medicare baseline (a markup of 483%). 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 |
|---|---|---|
| Humana | $508 - $2,135 | 208% |
| Tricare | $508 - $2,135 | 208% |
| Medicare (plans) | $513 - $2,156 | 210% |
| Blue Cross Blue Shield | $556 | 228% |
| Ambetter / Centene | $558 - $2,348 | 229% |
| Coventry - All Other Plans | $914 - $3,843 | 375% |
| Preferred Healthcare-All Plans | $964 - $4,056 | 395% |
| Health Partners Of Kansas - All Plans | $964 - $4,056 | 395% |
| Wppa/Providers Care-All Plans | $1,421 - $5,977 | 583% |
Consumer Guidance & Cost Commentary
For patients with high-deductible plans, paying cash directly for this MRI procedure at Memorial Hospital in Abilene, KS, may be the most cost-effective option. The facility's cash median rate is $2,642, which is notably higher than the state average for this service. However, commercial insurance plans often negotiate rates that exceed the cash price; for instance, the median negotiated rate across payers is $1,421, while some plans like Coventry and Preferred Healthcare have negotiated rates as high as $3,843 and $4,056 respectively. Because these commercial rates are inflated by administrative costs and contract dynamics, self-paying can sometimes result in lower out-of-pocket costs, provided the patient qualifies for the cash price. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the higher administrative markups inherent in insurance billing cycles.
It is important to understand that the $2,642 listed as the gross charge is the facility's maximum list price, not the amount you will likely pay. This figure serves as a benchmark for balance billing, where out-of-network providers or unexpected ancillary services could theoretically bill the difference between the chargemaster and the insurance allowed amount. Fortunately, federal protections under the No Surprises Act generally prevent balance billing for emergency care and non-emergency services at in-network facilities, though patients should still review their itemized bills to ensure no unbundled codes or services not rendered are included. When reviewing your statement, compare the final amount to the Medicare benchmark of $243.77; commercial rates are often significantly higher than this federal baseline due to the