MRI lower back without contrast at Saint Agnes Medical Center. CPT 72148.
What Saint Agnes Medical Center publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$153cash price (self-pay)
$153list price
$43.67–$3,327range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Rx Allwin | Medicare | $68.36 |
| Molina Medicare Advantage | Medicare | $68.36 |
| Correctcare Integrated Health | Correct Care Integrated Health Medicai | $156 |
| Medi-Cal Healthnet | Health Net Medicaid | $169 |
| Medi-Cal Blue Cross | Anthem Medicaid | $180 |
| Medi-Cal Healthnet | Adventist Medicaid | $194 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $301 |
| Blue Cross - CA (Anthem) Medicare Advantage | Anthem BCBS Medicare Adv | $301 |
| Humana Medicare Advantage | Humana Ipa Meritage Medicare Advantage | $301 |
| Humana Central Valley Medpro | Cvhp | $307 |
| Healthnet Medicare Advantage | Healthnet Medicare Advantage | $313 |
| Welbe Health | Welbe Health | $316 |
| Brand New Day Medicare Advantage | Brand New Day Medicare Advantage | $316 |
| Kaiser Permanente Medicare Advantage | Kaiser Medicare Advantage | $316 |
| Healthnet Medicare Advantage | Key Medical Group | $316 |
| Central Health Medicare Advantage | Central Health Plan Medicare Advan | $316 |
| Humana Medicare Advantage | Key Medical Group | $316 |
| Align Senior Care | Ally Senior Care Medicare Advantage | $353 |
| Blue Cross - CA (Anthem) Medicare Advantage | Anthem Medicare Adv Ipa | $361 |
| Kaiser Permanente | Kaiser HMO | $537 |
| Advantek Central Usd | Anthem Bc Advantek | $636 |
| Blue Cross - TX | Anthem Bc HMO | $636 |
| Blue Cross - Wi (Anthem) | Anthem Bc HMO | $636 |
| Blue Cross - IL | Anthem Bc HMO | $636 |
| Blue Cross - Mn | Anthem Bc HMO | $636 |
| Blue Cross - In (Anthem) | Anthem Bc HMO | $636 |
| Blue Cross - Mo (Anthem) | Anthem Bc HMO | $636 |
| Aetna | Aetna | $942 |
| United Healthcare | United Healthcare Select | $1,195 |
| Coventry | Coventry | $1,314 |
Inpatient
$177cash price (self-pay)
$177list price
$43.67–$177range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Wc Yankee Trails | Workers Comp | $59.52 |
| Wc Walmart | Workers Comp | $59.52 |
| Wc California State Ins Fund | Workers Comp | $59.52 |
| Wc California State Comp Ins | Workers Comp | $59.52 |
| Wc Am Trust N America | Workers Comp | $59.52 |
| Wc Alaska National Ins | Workers Comp | $59.52 |
| Wc Aims | Workers Comp | $59.52 |
| Wc Advantage | Workers Comp | $59.52 |
| Wc Icw Group | Workers Comp | $59.52 |
| Wc Hab | Workers Comp | $59.52 |
| Wc Fresno Unified Emp | Workers Comp | $59.52 |
| Wc Broadspire | Workers Comp | $59.52 |
| Wc Guarantee Insurance | Workers Comp | $59.52 |
| Wc Guard Insurance Company | Workers Comp | $59.52 |
| Wc Sentry | Workers Comp | $59.52 |
| Cmh Northern Lakes County | Medicaid | $59.52 |
| Cmh Van Buren County | Medicaid | $59.52 |
| Cmh Ottawa County | Medicaid | $59.52 |
| Cmh Washtenaw County | Medicaid | $59.52 |
| Cmh Wayne Cty/Com Liv Svcs | Medicaid | $59.52 |
| Cmh Monroe County | Medicaid | $59.52 |
| Cmh Misc | Medicaid | $59.52 |
| Cmh Muskegon County | Medicaid | $59.52 |
| Cmh Montcalm County | Medicaid | $59.52 |
| Wc Ford Motor | Workers Comp | $59.52 |
| Wc Asu Risk Mgt | Workers Comp | $59.52 |
| Wc Mitchell Frankenmuth | Workers Comp | $59.52 |
| Wc Federal Black Lung | Workers Comp | $59.52 |
| Molina Medicare Advantage | Medicare | $68.36 |
| Rx Allwin | Medicare | $68.36 |
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