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MRI lower back without contrast at La Palma Intercommunity Hospital. CPT 72148.

What La Palma Intercommunity Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.

Outpatient / ER

$305cash price (self-pay)
$6,399list price
$181–$6,399range insurers pay
Insurance planNegotiated rate
Blue Shield Of Promise | Blue Shield Of Promise Medi-Cal$181
Caloptima | Caloptima Medi-Cal IP$181
COUNTY OF ORANGE (MSN) | COUNTY OF ORANGE (MSN) Medi-Cal$181
LA Care Health Plan | L.A Care Health Plan Medi-Cal$181
Molina | Molina Medi-Cal$181
Traditional Medi - Cal | Traditional Medi-Cal$181
Health Net of CA | Health Net Of CA Medi-Cal$194
Blue Shield Of Promise | Blue Shield Of Promise Medicare$305
Blue Shiled Of CA Triwest | Blue Shield of CA TriWest Healthcare VA$305
Health Net Federal Services Tricare | Health Net Federal Services Tric$305
Health Net of CA | Health Net Of CA Medicare$305
LA Care Health Plan | L.A Care Health Plan Covered Direct$305
LA Care Health Plan | L.A Care Health Plan Duals$305
Managed Health Network | Managed Health Network Medicare$305
Molina | Molina Exchange$305
Molina | Molina Medicare$305
Renal Payer Solutions | Renal Payor Solutions Medicare$305
Traditional Medicare | Traditional Medicare$305
Tricare | Tricare$305
Verda HealthPlan | Verda HealthPlan Medicare$305
Brand New Day | Brand New Day Medicare$308
Imperial Health Plan Of CA | Imperial Health Plan Of CA Medicare$324
COVENTRY fka AETNA Worker Comp | COVENTRY - fka AETNA - Workers Compen$390
CA FOUNDATION FOR MEDICAL CARE | CA FOUNDATION FOR MEDICAL CARE Worker$402
Workers Compensation | Workers Compensation$402
Employer Direct Healthcare | Employer Direct Healthcare Surgery Plus$428
Health Net of CA | Health Net Of CA Commercial PPO$429
Health Net of CA | Health Net Of CA Commercial Ins Exchange$446
Brand New Day | Brand New Day Exchange$458
Anthem Blue Cross | Anthem Blue Cross Medi-Cal$867
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All common services at La Palma Intercommunity Hospital