MRI lower back without contrast at San Gabriel Valley Medical Center. CPT 72148.
What San Gabriel Valley Medical Center publishes for this service, straight from its standard-charges file, last updated July 1, 2026.
Outpatient / ER
$2,393cash price (self-pay)
$7,976list price
$58.43–$7,976range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross Medi-Cal Managed Care | Blue Cross Medi-Cal | $58.43 |
| AltaMed Health Network | AltaMed Health Network Medi-Cal | $186 |
| Beverly Hospital | BEVERLY HOSPITAL MCL | $186 |
| Emanate Health | Emanate Health Medi-Cal | $186 |
| HealthNet Medi-Cal Non-Contract | Health Net Medi-Cal | $186 |
| LA Care Health Plan | LA Care Healthy Kids and Medi-Cal Managed Care | $214 |
| United Healthcare Senior Medicare Advantage | United Healthcare Senior | $258 |
| Care 1st Health Plan | BLUE SHIELD PROMISE HEALTH PLAN MCAL | $375 |
| Care 1st Health Plan | Care 1st Health Plan Healthy Families | $405 |
| AHMC Medi-Cal Reciprocity | AHMC Medi-Cal Reciprocity | $465 |
| AHMC Reciprocity | AHMC Reciprocity Commercial | $465 |
| AHMC Reciprocity | AHMC Reciprocity Sr | $465 |
| Molina Healthcare of California | Molina Medi-Cal | $478 |
| Aetna Health of California | Aetna | $486 |
| Care 1st Health Plan | BLUE SHIELD PROMISE HEALTH HMO | $600 |
| Care 1st Health Plan | BLUE SHIELD PROMISE HEALTH SENIOR | $600 |
| Affiliated Health Fund | Affiliated Health Fund | $700 |
| AIDS Healthcare Foundation | AIDS Hlth Fndn/Positive Hlth Mcal | $826 |
| Avanti | Avanti Medi-cal | $826 |
| Healthy Way LA | Healthy Way LA | $826 |
| Hollywood Presbyterian Adv Med Mcal | Hollywood Presbyterian Adv Med M | $826 |
| Hollywood Presbyterian Medpoint Mcal | Hollywood Presbyterian Medpoint | $826 |
| Medi-Cal/Medicaid | Medi-Cal/Medicaid | $826 |
| Blue Cross Medi-Cal Managed Care | Blue Cross Healthy Families | $908 |
| Central Health Plan | Central Health Plan HMO | $1,000 |
| Blue Cross of CA | Blue Cross of CA | $1,684 |
| AIDS Healthcare Foundation | AIDS Healthcare Foundation | $1,800 |
| Cigna Healthcare | Cigna HMO/PPO/Open Access/Network | $2,059 |
| Health Net | Health Net Healthy Families/Kids/AIM | $2,765 |
| Health Net | Health Net Enhanced PPO | $3,844 |
Inpatient
$2,393cash price (self-pay)
$7,976list price
$6,381–$7,976range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Beech Street | Beech Street PPO | $6,381 |
| MultiPlan | MultiPlan PPO | $7,178 |
| PPO Next | PPO Next | $7,178 |
| Other Non Contracted Commercial | Other Non Contracted Commercial | $7,976 |
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