MRI, lower back (no contrast)
Facility: Bob Wilson Memorial Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $2,652
- Cash Discount Price: $1,298
- vs. Medicare Baseline: 10.88x 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 1088% of the Medicare baseline (a markup of 988%). 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 |
|---|---|---|
| Centura Employee Plan | $543 | 223% |
| Blue Cross Blue Shield | $737 | 302% |
| Aetna | $1,039 - $2,597 | 426% |
| Medicare (plans) | $1,039 | 426% |
| Humana | $1,039 | 426% |
| UnitedHealthcare | $1,039 - $2,707 | 426% |
| Kansas Health | $1,039 | 426% |
| Multiplan | $2,921 - $3,019 | 1198% |
| Health Partners Of Kansas | $3,051 | 1252% |
| Wppa | $3,084 | 1265% |
Consumer Guidance & Cost Commentary
For this MRI of the lower back (no contrast) at Bob Wilson Memorial Hospital in Ulysses, KS, the cash price of $1,298 is notably lower than the facility's gross charge of $3,246, representing a significant reduction for patients paying directly. While the data does not provide specific state or county average figures for comparison, the facility's cash rate stands in contrast to the commercial negotiated rates, where the median negotiated amount is $2,652 and the median paid amount is $706. The Medicare benchmark for this service is set at $243.77, which serves as the objective baseline for evaluating the markup on commercial rates; commercial negotiated rates for this procedure average between 200% and 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of Medicare.
Patients with high-deductible plans may find that paying cash directly is more cost-effective than relying on insurance, as the cash price of $1,298 is lower than the median negotiated rate of $2,652 and several individual payer high-end rates, such as the $3,084 rate from WPPA. However, patients should be aware that insurance plans often have different negotiated ceilings; for instance, while Aetna offers a range from $1,039 to $2,597, Medicare plans have a fixed allowed amount of $1,039. To minimize costs, patients should ask the hospital about "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the