MRI lower back without contrast at Santa Rosa Medical Center. CPT 72148.
What Santa Rosa Medical Center publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$2,167cash price (self-pay)
$14,445list price
$153–$11,556range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup Medicaid | Amerigroup Medicaid FL | $167 |
| FL Community Care | FL Community Care | $176 |
| Veterans Eval Services | Veterans Eval Services | $228 |
| NODE Humana MCR PPO PFFS | NODE Humana MCR PPO PFFS | $233 |
| NODE Tricare | NODE Tricare | $237 |
| NODE Aetna MCR ADV | NODE Aetna MCR ADV | $245 |
| Node BCBS FL Mcr Adv | Node BCBS FL Mcr Adv | $245 |
| NODE Cigna Healthspring MCR ADV | NODE Cigna Healthspring MCR ADV | $245 |
| NODE Humana MCR HMO POS | NODE Humana MCR HMO POS | $245 |
| NODE Medicare Non Par | NODE Medicare Non Par | $245 |
| NODE Medicare Traditional | NODE Medicare Traditional | $245 |
| Node UHC Mcr Adv | Node UHC Mcr Adv | $245 |
| NODE ChampVA | NODE ChampVA | $249 |
| Hospice of NW FL | Hospice of NW FL | $249 |
| NODE United Optum VA CCN | NODE United Optum VA CCN | $249 |
| Node Va | Node Va | $249 |
| NODE Wellcare MCR ADV | NODE Wellcare MCR ADV | $257 |
| GEO Group | GEO Group | $311 |
| NODE US Dept of Labor | NODE US Dept of Labor | $311 |
| Prime Health Work Comp FL | Prime Health Work Comp FL | $451 |
| Oscar | Oscar | $462 |
| Florida Workers Compensation | FL Work Comp | $465 |
| Florida State Auto Insurance | State Auto Insurance FL | $498 |
| SUNSHINE HEALTH AMBETTER MARKETPLACE | Sunshine State Health Plan Comm | $596 |
| Blue Cross and Blue Shield of Florida | BCBS FL BSL | $1,423 |
| Blue Cross and Blue Shield of Florida | BCBS FL MBN | $1,423 |
| Blue Cross and Blue Shield of Florida | BCBS FL HMO | $1,502 |
| BCBS FL Sbn | BCBS FL Sbn | $1,502 |
| United Healthcare | UHC APA | $1,744 |
| Blue Cross and Blue Shield of Florida | BCBS FL NWB | $1,789 |
Inpatient
$5,056cash price (self-pay)
$14,445list price
$2,802–$11,556range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CHS Group Health Plan UMR | CHS Group Health Plan UMR | $2,802 |
| Cigna | Cigna ALL | $3,265 |
| Self Pay | Self Pay | $3,322 |
| Aetna Health | Aetna INTL Passport | $8,104 |
| Prime Health Services | Prime Health | $11,556 |
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