MRI, lower back (no contrast)
Facility: Wamego Health Center
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $156
- Cash Discount Price: $1,694
- vs. Medicare Baseline: 0.64x 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 |
|---|---|---|
| UnitedHealthcare | $58 - $234 | 24% |
| Aetna | $60 - $243 | 25% |
| Medicaid / KanCare | $60 - $250 | 25% |
| Providrs Care | $94 - $270 | 39% |
| Tricare | $338 | 139% |
| Blue Cross Blue Shield | $726 - $764 | 298% |
Consumer Guidance & Cost Commentary
For the MRI, lower back (no contrast) procedure at Wamego Health Center, the cash median price is $1,694.00, which is significantly lower than the facility's gross charge of $4,236.00. While insurance plans like UnitedHealthcare, Aetna, and Medicaid/KanCare have negotiated rates ranging from $58 to $250, these amounts often represent the maximum allowed amount rather than the actual cost to the patient. If you have a high-deductible plan, paying the cash price upfront may be more affordable than your insurance's negotiated rate, especially since the facility offers a prompt-pay discount that can further reduce the bill. It is crucial to ask the billing department about self-pay or prompt-pay discounts before scheduling to avoid being billed the full negotiated amount later.
The facility's pricing is benchmarked against Medicare, which sets a baseline of $243.77 for this service. The cash price of $1,694.00 is approximately 6.9 times the Medicare amount, reflecting the administrative costs and profit margins inherent in commercial billing. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services are not covered. To ensure accuracy, always request a detailed, itemized bill before paying, as summary invoices often hide unbundled codes or services not rendered. Disputing errors in writing is the most effective way to reduce medical debt, as over 80% of hospital bills contain some form of billing error.