MRI, lower back (no contrast)
Facility: Aurora Medical Center
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $1,352
- Cash Discount Price: $2,110
- vs. Medicare Baseline: 5.55x 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 555% of the Medicare baseline (a markup of 455%). 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 |
|---|---|---|
| Aurora Caregiver | $650 | 267% |
| Blue Cross Blue Shield | $755 - $3,587 | 310% |
| UnitedHealthcare | $767 - $3,553 | 315% |
| Healthpartners | $954 - $3,165 | 391% |
| Centivo | $1,038 | 426% |
| Common Ground | $1,083 | 444% |
| Aetna | $1,114 - $3,486 | 457% |
| Health Payment Systems | $1,170 | 480% |
| Quartz One | $1,200 | 492% |
| Molina Exchange | $1,273 | 522% |
| Hs Technology | $1,350 | 554% |
| Quartz Group | $1,350 | 554% |
| Everpointe Elite | $1,352 | 555% |
| Trilogy | $1,520 | 624% |
| Wisconsin Physician Service | $1,636 - $1,722 | 671% |
| Health Eos Plus | $2,532 | 1039% |
| Cigna | $2,550 - $3,570 | 1046% |
| Health Eos | $3,376 | 1385% |
Consumer Guidance & Cost Commentary
For this MRI of the lower back (no contrast) at Aurora Medical Center in Grafton, WI, the cash median rate is $2,110. This facility, a voluntary non-profit acute care hospital, reports a gross charge of $4,220 and a median negotiated rate of $1,352 across 18 payers. While the cash price is the baseline for self-pay patients, it is important to note that insurance members may face higher costs depending on their specific plan; for instance, Blue Cross Blue Shield ranges from $755 to $3,587 per plan, and UnitedHealthcare ranges from $767 to $3,553. Patients with high-deductible plans should consider that paying the cash rate of $2,110 upfront could be more economical than the negotiated rates charged by some insurers, provided the facility offers a prompt-pay discount which is recommended to be requested before scheduling.
The Medicare benchmarking rate for this service is $243.77, which serves as the federal baseline for evaluating the facility's pricing markup. The cash median of $2,110 represents a significant multiple of this Medicare amount, illustrating the typical commercial markup structure where negotiated rates often average between 200% and 300% of the Medicare rate. Consumers should be aware that summary bills provided by the hospital may obscure individual charges, so requesting a full itemized CPT-coded statement is essential to identify any unbundled codes or services not rendered. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, meaning any surprise bills should be disputed with