CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Mercy Hospital Carthage

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,573
Cash Discount Price: $1,863
vs. Medicare Baseline: 6.45x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Mercy Hospital Carthage is $1,573. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,863. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.45x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.

Cash / Self-Pay

$1,863

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,573

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: $1,863 (764%)

Insurance Median: $1,573 (645%)

Cash: $1,863 (764% of Medicare)

Ins. Median: $1,573 (645% 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 645% of the Medicare baseline (a markup of 545%). 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
Aetna	$106 - $2,551	43%
Humana	$106 - $860	43%
Medicaid / KanCare	$106 - $1,573	43%
Blue Cross Blue Shield	$131 - $1,049	54%
Medicare (plans)	$226 - $848	93%
UnitedHealthcare	$317 - $2,493	130%
Cherokee Nation Health Serv Contracted [320066]	$787	323%
Cigna	$787 - $2,579	323%
Cross Timbers Hospice [20098]	$787	323%
Dept Of Veteran Affairs Contracted [320106]	$787	323%
Elara Caring Aspire Hospice [20433]	$787	323%
Globalhealth Contracted [320145]	$787	323%
Halo Hcr Inc Hospice Contracted [320432]	$787	323%
Halo Hcr Inc Hospice [20432]	$787	323%
Indian Health Service Contracted [320198]	$787	323%
Kindful Hospice Contracted [320434]	$787	323%
Kindful Hospice [20434]	$787	323%
Medical Associates Health Contracted [320444]	$787	323%
Mercy Hospice Okc [20252]	$787	323%
Mercy Mgd Behavioral Health Contracted [320259]	$787	323%
Pace Of The Ozarks Contracted [320518]	$787	323%
Provider Partners Health Plans Contracted [320450]	$787	323%
Qual Choice Contracted [320325]	$787	323%
Tricare	$790	324%
Point C Contracted [320238]	$1,003 - $2,579	411%
Health Systems Inc Contracted [320174]	$1,232	505%
Insurance System Inc Contracted [320465]	$1,232	505%
Administrative Payor Contracted [320005]	$1,290	529%
Centivo Contracted [320505]	$1,318	541%
Healthscope Contracted [320182]	$1,493	612%
Ambetter / Centene	$1,573	645%
Home State Health Plan Contracted [320187]	$1,573	645%
Novasys Contracted [320285]	$1,573	645%
United Medical Resources Contracted [320454]	$1,719 - $2,579	705%
Benefit Management Contracted [320052]	$1,720 - $2,493	706%
Auxiant Contracted [320462]	$1,863 - $2,436	764%
Healthlink Contracted [320179]	$1,863 - $2,665	764%
Preferred Health Plan Contracted [320522]	$1,863	764%
Workers Comp [20426]	$2,293 - $2,866	941%
90 Degree Benefits Contracted [320436]	$2,436	999%
Aither Health Contracted [320449]	$2,436	999%
Ebms Contracted [320493]	$2,436	999%
Edison Health Solutions Contracted [320502]	$2,436	999%
Imagine 360 Contracted [320494]	$2,436	999%
Mercy Benefit Admin Contracted [320251]	$2,436 - $2,579	999%
Reflect Health Contracted [320492]	$2,436	999%
Show-Me Health Administrators Contracted [320483]	$2,436	999%
Yuzu Health Contracted [320521]	$2,436	999%
Medica Contracted [320239]	$2,482	1018%
Evolutions Health Care Contracted [320124]	$2,493	1023%
First Health Contracted [320128]	$2,493	1023%
Multiplan Contracted [320270]	$2,493	1023%
Private Health Care Systems Contracted [320320]	$2,493	1023%
American Healthcare Alliance Contracted [320020]	$2,579	1058%
Ppo Plus Contracted [320310]	$2,579	1058%
Usa Managed Care Org Contracted [320429]	$2,579	1058%

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 $1,863.
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 Carthage 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.