MRI lower back without contrast at Dorminy Medical Center. CPT 72148.
What Dorminy Medical Center publishes for this service, straight from its standard-charges file, last updated May 6, 2026.
Outpatient / ER
$882cash price (self-pay)
$1,765list price
$208–$1,677range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Medicare Advantage | Advantage | $208 |
| Humana Medicare Advantage | Advantage | $208 |
| Anthem Blue Cross Medicare Advantage | Advantage | $208 |
| United HealthCare Medicare Advantage | Advantage | $208 |
| Anthem Blue Cross Pathway | Pathway | $580 |
| Anthem Blue Cross HMO | HMO | $725 |
| Anthem BCBS PPO | PPO | $725 |
| HealthSmart | All Commercial Plans | $1,324 |
| Aetna Commercial | PPO/HMO | $1,412 |
| Provider Network of America | All Commercial Plans | $1,500 |
| Principal Edge Network | All Commercial Plans | $1,535 |
| United HealthCare Commercial | PPO/HMO | $1,535 |
| Cigna Commercial | PPO/HMO | $1,553 |
| Humana ChoiceCare | All Commercial Plans | $1,553 |
| Novanet | All Commercial Plans | $1,588 |
| Unicare | All Commercial Plans | $1,588 |
| PHCS | All Commercial Plans | $1,588 |
| MultiPlan | PPO/HMO | $1,588 |
| Three Rivers Provider Network | All Commercial Plans | $1,677 |
Inpatient
$882cash price (self-pay)
$1,765list price
$1,324–$1,677range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| HealthSmart | All Commercial Plans | $1,324 |
| Aetna Commercial | PPO/HMO | $1,412 |
| Provider Network of America | All Commercial Plans | $1,500 |
| Principal Edge Network | All Commercial Plans | $1,535 |
| United HealthCare Commercial | PPO/HMO | $1,535 |
| Cigna Commercial | PPO/HMO | $1,553 |
| Humana ChoiceCare | All Commercial Plans | $1,553 |
| Novanet | All Commercial Plans | $1,588 |
| Unicare | All Commercial Plans | $1,588 |
| PHCS | All Commercial Plans | $1,588 |
| MultiPlan | PPO/HMO | $1,588 |
| Three Rivers Provider Network | All Commercial Plans | $1,677 |
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