MRI lower back without contrast at UCLA Santa Monica Medical Center. CPT 72148.
What UCLA Santa Monica Medical Center publishes for this service, straight from its standard-charges file, last updated March 29, 2026.
Outpatient / ER
—cash price (self-pay)
—list price
$186–$881range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| LA care Medi-Cal HMO | Medi-Cal HMO | $186 |
| Aetna Medicare | Medicare | $307 |
| Redlands Community Medicare | Medicare | $307 |
| St. Jude | Medicare HMO | $307 |
| TriWest Healthcare Alliance | Other Government | $307 |
| UCLA Health Medicare Advantage Plan | Medicare Advantage | $307 |
| Blue Shield | Medicare Advantage | $307 |
| LA Care DSNP | Medicare HMO | $307 |
| Monarch | Medicare | $307 |
| UHC Mediare Advantage | Medicare Advantage | $307 |
| Health Plan of Nevada Medicare | Medicare | $310 |
| Anthem Vivity-Anthem HMO | All Products-HMO | $335 |
| Providence Healthcare | Medicare | $338 |
| Torrance Memorial Medicare | HMO-Medicare | $338 |
| Central Health Plan | Medicare HMO | $367 |
| HealthSmart | Workers Compensation | $368 |
| Anthem Vivity, Anthem HMO | HMO-NonCity of LA | $376 |
| SCAN | Medicare | $415 |
| LA Care Covered CA | HMO | $429 |
| Centivo | PPO | $737 |
| Health Plan of Nevada Commercial | All Products | $855 |
| Optum | Medicare | $881 |
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