MRI, lower back (no contrast)
Facility: Oakleaf Surgical Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $236
- Cash Discount Price: $3,590
- vs. Medicare Baseline: 0.97x 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $236 - $3,220 | 97% |
| Dean Health Plan | $236 | 97% |
| Group Health Cooperative Of Eau Claire | $236 | 97% |
| Healthpartners | $236 | 97% |
| Humana | $236 | 97% |
| Medica | $236 | 97% |
| Quartz Health Solutions | $236 | 97% |
| Security Health Plan Of Wi | $236 - $876 | 97% |
| Ucare Wi | $236 | 97% |
| UnitedHealthcare | $236 | 97% |
| Alliance | $1,182 | 485% |
Consumer Guidance & Cost Commentary
For this MRI, lower back (no contrast) procedure at Oakleaf Surgical Hospital in Altoona, WI, the cash median rate of $3,590 is significantly lower than the facility's gross charge of $3,988 and the Medicare benchmark of $243.77. While the facility is an Acute Care Hospital owned by a Physician, the data indicates a median negotiated rate of $236 across 11 payers, which is notably lower than the cash price. This scenario highlights a common billing dynamic where cash-pay patients with high-deductible plans might find the cash rate more affordable than what their insurance would allow, as the negotiated rates from carriers like Blue Cross Blue Shield and Alliance range from $236 to $1,182. It is important to verify if your specific plan falls into the lower tier of these negotiated rates before scheduling to avoid potential balance billing if you are treated as out-of-network, though the No Surprises Act provides protections for emergency care and non-emergency services at in-network facilities.
To ensure you receive the most accurate billing, it is recommended to request an itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. Before finalizing payment, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if paid upfront, bypassing the administrative overhead of claims processing. If a balance bill arises from an out-of-network provider, patients should dispute the charge with their insurer and request a No Surprises Act audit rather than paying immediately