CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Mercy Hospital Joplin

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $935
Cash Discount Price: $2,363
vs. Medicare Baseline: 3.84x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Mercy Hospital Joplin is $935. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,363. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.84x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.

Cash / Self-Pay

$2,363

Average discount available for prompt cash payment at this facility.

Insurance Median

$935

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $2,363 (969%)

Insurance Median: $935 (384%)

Cash: $2,363 (969% of Medicare)

Ins. Median: $935 (384% of 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 384% of the Medicare baseline (a markup of 284%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

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	$102 - $2,651	42%
Indian Health Service Contracted [320198]	$102 - $2,363	42%
Aetna	$106 - $215	43%
Humana	$106 - $1,091	43%
Medicaid / KanCare	$106 - $432	43%
Champva [20065]	$215	88%
Cherokee Nation Health Serv Contracted [320066]	$215	88%
Cigna	$215 - $935	88%
Cross Timbers Hospice [20098]	$215	88%
Dept Of Veteran Affairs Contracted [320106]	$215	88%
Elara Caring Aspire Hospice [20433]	$215	88%
Globalhealth Contracted [320145]	$215	88%
Halo Hcr Inc Hospice Contracted [320432]	$215	88%
Halo Hcr Inc Hospice [20432]	$215	88%
Kindful Hospice Contracted [320434]	$215	88%
Kindful Hospice [20434]	$215	88%
Medicare (plans)	$215 - $226	88%
Mercy Hospice Okc [20252]	$215	88%
Mercy Mgd Behavioral Health Contracted [320259]	$215	88%
Pace Of The Ozarks Contracted [320518]	$215	88%
Provider Partners Health Plans Contracted [320450]	$215	88%
Qual Choice Contracted [320325]	$215	88%
Tricare	$215	88%
UnitedHealthcare	$215 - $518	88%
Centivo Contracted [320505]	$219	90%
Healthscope Contracted [320182]	$274	112%
Ambetter / Centene	$298	122%
Home State Health Plan Contracted [320187]	$298	122%
Novasys Contracted [320285]	$298	122%
Providrs Care Network Contracted [320484]	$447	183%
United Medical Resources Contracted [320454]	$518 - $846	212%
Health Choice Contracted [320166]	$604	248%
Healthlink Contracted [320179]	$868 - $2,363	356%
Medica Contracted [320239]	$1,101	452%
90 Degree Benefits Contracted [320436]	$1,109	455%
Mercy Benefit Admin Contracted [320251]	$1,109 - $2,073	455%
Show-Me Health Administrators Contracted [320483]	$1,109 - $1,165	455%
Point C Contracted [320238]	$1,273 - $2,909	522%
Benefit Management Contracted [320052]	$1,563	641%
Health Systems Inc Contracted [320174]	$1,563	641%
Insurance System Inc Contracted [320465]	$1,563	641%
Administrative Payor Contracted [320005]	$1,636	671%
Aither Health Contracted [320449]	$2,073	850%
Auxiant Contracted [320462]	$2,073 - $2,363	850%
Ebms Contracted [320493]	$2,073	850%
Edison Health Solutions Contracted [320502]	$2,073	850%
Imagine 360 Contracted [320494]	$2,073	850%
Reflect Health Contracted [320492]	$2,073	850%
Yuzu Health Contracted [320521]	$2,073	850%
Preferred Health Plan Contracted [320522]	$2,363	969%
First Health Contracted [320128]	$2,476	1016%
American Healthcare Alliance Contracted [320020]	$2,545	1044%
Multiplan Contracted [320270]	$2,800	1149%
Private Health Care Systems Contracted [320320]	$2,800	1149%
Usable Contracted [320409]	$2,800	1149%
Point C [20238]	$2,909	1193%
Workers Comp [20426]	$2,909 - $3,636	1193%
Usa Managed Care Org Contracted [320429]	$3,200	1313%
Ppo Plus Contracted [320310]	$3,272	1342%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $2,363.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72148.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Joplin is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72148.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.