MRI lower back without contrast at Dodge County Hospital Authority. CPT 72148.
What Dodge County Hospital Authority publishes for this service, straight from its standard-charges file, last updated May 14, 2026.
Outpatient / ER
—cash price (self-pay)
$3,889list price
$1.00–$3,500range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UHC Commercial | PPO | $1.00 |
| Aetna Medicare Advantage | HMO | $208 |
| UHC Medicare Advantage | HMO | $208 |
| Humana Medicare PPO | PPO | $208 |
| Peach State Medicaid | HMO | $604 |
| Amerigroup Medicaid | PPO | $691 |
| BCBS Pathway/HMO | HMO | $1,364 |
| BCBS PPO/Par | PPO | $1,689 |
| Aetna | PPO | $2,917 |
| Cigna | PPO | $3,500 |
Inpatient
—cash price (self-pay)
$3,889list price
$1.00–$2,075range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | PPO | $1.00 |
| UHC Commercial | PPO | $1.00 |
| Peach State Medicaid | HMO | $1.00 |
| BCBS PPO/Par | PPO | $1,614 |
| Amerigroup Medicaid | PPO | $2,075 |
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