MRI, lower back (no contrast)
Facility: Susan B Allen Memorial Hospital
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $554
- Cash Discount Price: $1,254
- vs. Medicare Baseline: 2.27x 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 227% of the Medicare baseline (a markup of 127%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 144% |
| Providrs Care | $757 | 311% |
Consumer Guidance & Cost Commentary
For the MRI of the lower back (no contrast) at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $1,254.00, which is significantly lower than the facility's negotiated rates of $554.00 paid by UnitedHealthcare and Providrs Care. While commercial insurance contracts often result in higher out-of-pocket costs for patients with high deductibles, this procedure's cash price remains competitive relative to the broader market. The facility's location in El Dorado (ZIP 67042) places it within a specific geographic context where pricing transparency is vital; patients should verify their specific plan's allowed amount before scheduling, as in-network rates can vary widely even within the same hospital system.
To ensure you are not overpaying, it is recommended to request an itemized billing audit before finalizing payment, as summary bills often obscure individual charges that could be disputed. Additionally, since the Medicare benchmark for this service is $243.77, the commercial negotiated rates represent a substantial markup compared to the federal baseline, which serves as the objective standard for fair pricing. If you choose to pay cash, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if settled within 30 days, effectively bypassing the administrative overhead associated with insurance claims processing.