MRI lower back without contrast at Banner Payson Medical Center. CPT 72148.
What Banner Payson Medical Center publishes for this service, straight from its standard-charges file, last updated September 22, 2026.
Outpatient / ER
$934cash price (self-pay)
$1,883list price
$167–$1,695range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Arizona Physicians IPA | Medicaid | $167 |
| Banner University Health Plan | AZ Medicaid - AHCCCS | $167 |
| Health Choice Arizona, Inc. | Medicaid | $167 |
| Health Net | Medicaid | $167 |
| Mercy Care | Mercy Medicaid | $167 |
| Aetna | Banner Employee Plans | $511 |
| Blue Cross Blue Shield of Arizona | BXBSAZ Neighborhood | $741 |
| Banner Health | Medicare Advantage | $772 |
| Aetna | Medicare Advantage | $772 |
| Arizona Physicians IPA | Medicare Advantage | $772 |
| Banner University Health Plan | Medicare Advantage | $772 |
| Blue Cross Blue Shield of Arizona | Medicare Advantage | $772 |
| Cigna Healthcare of Arizona, Inc. | HMO Medicare Advantage Plan/PPO Me | $772 |
| Gila River Health Care Corporation | Managed Care Program | $772 |
| Health Choice Arizona, Inc. | Medicare Advantage | $772 |
| Health Net | Medicare | $772 |
| Kaiser Foundation Health Plan | Medicare Advantage | $772 |
| Mercy Care | Mercy Care Advantage | $772 |
| Blue Cross Blue Shield of Arizona | BCBSAZ Alliance/Blue HPN | $790 |
| Carekin | Medicare Advantage | $811 |
| Humana | Medicare Advantage | $818 |
| Blue Cross Blue Shield of Arizona | BXBSAZ Alliance CHS | $830 |
| National Healthcare Solutions Inc (NHSI) and VIP Universal Medical Ins | $847 |
| Plotkin Health | Plotkin Health | $847 |
| Arizona Priority Care | Medicare Advantage | $849 |
| Devoted Health Services | Medicare Advantage | $849 |
| Gold Kidney Health Plan | Medicare Advantage | $849 |
| Aetna | Joint Venture | $981 |
| Blue Cross Blue Shield of Arizona | BCBSAZ Workers Comp | $988 |
| Blue Cross Blue Shield of Arizona | Commercial | $988 |
Inpatient
$934cash price (self-pay)
$1,883list price
$847–$1,695range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| National Healthcare Solutions Inc (NHSI) and VIP Universal Medical Ins | $847 |
| Plotkin Health | Plotkin Health | $847 |
| Aetna | Medical Rental | $1,190 |
| Quiktrip Corporation | Commercial | $1,309 |
| Cigna Healthcare of Arizona, Inc. | Commerical/HMO Benefit Plan/Local | $1,461 |
| Arizona Medical Network | Commercial | $1,627 |
| Provider Network of America | Commercial | $1,695 |
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