MRI lower back without contrast at Providence Little Co of Mary Med Center San Pedro. CPT 72148.
What Providence Little Co of Mary Med Center San Pedro publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$2,179cash price (self-pay)
$6,225list price
$307–$2,124range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Managed Care Plan | $307 |
| Humana | Medicare Managed Care Plan | $313 |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $322 |
| Caremore | Medicare Managed Care Plan | $338 |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $362 |
| Unitedhealthcare | All Commercial Plans | $373 |
| Unitedhealthcare | Select/Navigate Hmo | $373 |
| La Care Health Plan | Covered Ca Exchange | $399 |
| Healthnet | Ambetter Hmo | $568 |
| Healthnet | Ambetter Ppo | $657 |
| Aetna | All Commercial Plans | $747 |
| Blue Shield | Epn/Ifp Benefit Exchange | $1,098 |
| Blue Shield | Tandem Ppo/Blue High Performance Ppo/Epo | $1,189 |
| Blue Shield | Hmo | $1,327 |
| Blue Shield | Ppo/Epo | $1,327 |
| Blue Cross | All Commercial Plans | $1,806 |
| Blue Shield | Medicare Managed Care Plan | $2,124 |
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All common services at Providence Little Co of Mary Med Center San Pedro