MRI lower back without contrast at San Dimas Community Hospital. CPT 72148.
What San Dimas Community Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$305cash price (self-pay)
$6,379list price
$181–$6,379range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AIDS Healthcare Foundation | Aids Health Care Foundation Medi-cal | $181 |
| Blue Shield of Promise | Blue Shield Of Promise Medi-Cal | $181 |
| Heritage Provider Network Inc | Heritage Provider Network Medi-Cal | $181 |
| LA Care Health Plan | L A Care Health Plan Medi-cal | $181 |
| Anthem Blue Cross | Anthem Blue Cross Medi-Cal | $190 |
| Health Net of CA | Health Net Of CA Medi-Cal | $194 |
| AIDS Healthcare Foundation | Aids Health Care Foundation MSSP | $305 |
| Anthem Blue Cross | Anthem Blue Cross Medicare | $305 |
| Blue Shield of CA | Blue Sheild Of CA Medicare | $305 |
| Blue Shield of CA | Blue Shield Of CA Triwest | $305 |
| Central Health Plan | Central Health Plan Medicare | $305 |
| Choice Physicians Network | Choice Physicians Network Medicare | $305 |
| Citrus Valley Physicians Group | Citrus Valley Physicians Group Commer | $305 |
| Citrus Valley Physicians Group | Citrus Valley Physicians Group Medi-c | $305 |
| Citrus Valley Physicians Group | Citrus Valley Physicians Group Medica | $305 |
| Elite Health Plan | Elite Health Plan (Medicare) | $305 |
| Health Excel Inc | Health Excel Inc Medicare | $305 |
| Health Net of CA | Health Net Federal Services Tricare | $305 |
| Health Net of CA | Health Net Of CA Cal Mediconnect | $305 |
| Health Net of CA | Health Net Of CA Medicare | $305 |
| Heritage Provider Network Inc | Heritage Provider Network Medicare | $305 |
| LA Care Health Plan | LA Care Health Plan Covered CA and Covered Direc | $305 |
| LA Care Health Plan | LA Care Health Plan Duals Cal MediConnect | $305 |
| LA Care Health Plan | LA Care Health Plan Medicare | $305 |
| Molina Healthcare | Molina Exchange | $305 |
| Brand New Day | Brand New Day Medicare | $308 |
| AIDS Healthcare Foundation | Aids Health Care Foundation Medicare | $311 |
| Imperial Health Plan Inc | Imperial Health Plan Medicare | $324 |
| Anthem Blue Cross | Anthem Blue Cross Workers Compensation | $342 |
| Heritage Provider Network Inc | Heritage Provider Network Commercial I | $382 |
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