MRI, lower back (no contrast)
Facility: Regional Medical Center
Billing Code: 72148 (CPT)
- CPT Billing Code: 72148
- Insurance Median: $870
- Cash Discount Price: $2,842
- vs. Medicare Baseline: 3.57x 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 357% of the Medicare baseline (a markup of 257%). 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 |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 357% |
Consumer Guidance & Cost Commentary
Self-pay patients should know that paying cash directly for this MRI, lower back (no contrast) procedure can result in the lowest possible cost, which is $2,842. While this cash rate is significantly higher than the Medicare benchmark of $243.77, it remains the most affordable option compared to the facility's negotiated rate of $870 paid by Medical Associates Health Plan - Tri. For individuals with high-deductible plans where their out-of-pocket costs might exceed the cash price, paying the $2,842 upfront could be more economical than relying on insurance, provided the patient has already met their deductible threshold.
This facility, a Critical Access Hospital in Manchester, IA, operates under a government-local ownership model, and its pricing structure reflects specific regional dynamics. The cash rate of $2,842 is notably lower than the facility's gross chargemaster price of $3,552, demonstrating the value of direct payment over the full list price. Although the facility does not provide specific county or state average data in this report, patients should be aware that the Medicare rate serves as the federal baseline for evaluating fair pricing, with commercial rates typically ranging between 200% and 300% of that benchmark. To ensure they receive the best financial outcome, patients are encouraged to request a prompt-pay discount or self-pay classification before scheduling their appointment to avoid automatic claims submission that would trigger the higher negotiated rate.