MRI lower back without contrast at Adventist Health Clearlake Hospital. CPT 72148.
What Adventist Health Clearlake Hospital publishes for this service, straight from its standard-charges file, last updated July 29, 2026.
Outpatient / ER
$1,545cash price (self-pay)
$4,957list price
$390–$8,179range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Bc Managed Mcal | Bc Managed Mcal | $390 |
| Medi-Cal | Medi-Cal | $390 |
| Kaiser Mcr Adv | Kaiser Mcr Adv | $1,041 |
| Blue Shield Mcr Adv | Blue Shield Mcr Adv | $1,041 |
| Tricare Blue Shield- All Plans | Tricare Blue Shield- All Plans | $1,041 |
| Blue Cross Mcr Adv | Blue Cross Mcr Adv | $1,083 |
| UHC Mcr Adv | UHC Mcr Adv | $1,145 |
| Blue Cross Exchange | Blue Cross Exchange | $1,687 |
| Blue Cross Non-Mcs | Blue Cross Non-Mcs | $1,875 |
| Ah Employee Health Plan - All Plans | Ah Employee Health Plan - All Pl | $2,082 |
| Blue Cross Mcs - All Other Plans | Blue Cross Mcs - All Other Plans | $2,250 |
| Aetna- All Plans | Aetna- All Plans | $3,704 |
| Western Growers- All Plans | Western Growers- All Plans | $3,718 |
| UHC Jll | UHC Jll | $3,927 |
| First Health- All Plans | First Health- All Plans | $3,966 |
| Healthnet- All Plans | Healthnet- All Plans | $4,065 |
| UHC All Payer - All Other Plans | UHC All Payer - All Other Plans | $4,134 |
| Foundation- All Plans | Foundation- All Plans | $4,213 |
| Humana- All Plans | Humana- All Plans | $4,213 |
| Phcs- All Plans | Phcs- All Plans | $4,213 |
| Health Mgmt Network- All Plans | Health Mgmt Network- All Plans | $4,213 |
| Interplan- All Plans | Interplan- All Plans | $4,461 |
| Kaiser- All Other Plans | Kaiser- All Other Plans | $4,461 |
| Three Rivers Provider Network- All Plans | Three Rivers Provider Netwo | $4,461 |
| Cigna- All Plans | Cigna- All Plans | $4,461 |
| Blue Shield Epn - All Other Plans | Blue Shield Epn - All Other Plans | $4,595 |
| Blue Shield Non-Epn | Blue Shield Non-Epn | $4,813 |
| Partnership Mcal - All Plans | Partnership Mcal - All Plans | $8,179 |
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