MRI lower back without contrast at Providence Mission Hospital - Mission Viejo. CPT 72148.
What Providence Mission Hospital - Mission Viejo publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,778cash price (self-pay)
$5,488list price
$261–$5,519range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Providence | Oscar All Commercial Plans | $261 |
| Aetna | Medicare Managed Care Plan | $307 |
| Blue Cross | Anthem Vivity City Of La Other Commercial Plan | $322 |
| Blue Cross | Anthem Vivity Non City Of La Other Commercial Plan | $362 |
| Unitedhealthcare | All Commercial Plans | $373 |
| Unitedhealthcare | Select/Navigate Hmo | $373 |
| Healthnet | Ambetter Hmo | $568 |
| Aetna | Gatekeeper Hmo | $1,837 |
| Blue Cross | Anthem Non-Mcs (Ind1, Ncx1, Ncx3) All Commercial Plans | $4,599 |
| Blue Cross | Anthem Mcs (Indx) All Commercial Plans | $5,519 |
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All common services at Providence Mission Hospital - Mission Viejo