MRI lower back without contrast at Fairview Park Hospital. CPT 72148.
What Fairview Park Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$10,411cash price (self-pay)
$10,411list price
$92.80–$9,370range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS | Hix | $175 |
| BCBS | Pathway | $175 |
| BCBS | HMO | $198 |
| BCBS | PPO | $212 |
| Aetna | HMO | $264 |
| Aetna | OpenAccess | $264 |
| Aetna | POS | $264 |
| Aetna | PPO | $264 |
| Aetna | QualifiedHealthPlan | $264 |
| Peach State (Ambetter) | HIX | $285 |
| Core Resources | COMM | $290 |
| Health One Alliance | COMMHIX | $290 |
| United | AllPayerAppendix | $518 |
| Prime Health | WORKERSCOMP | $608 |
| Employer's Health Network | WCOMP | $621 |
| Rockport United Network | WORKERSCOMP | $621 |
| Identity MCO | WorkersComp | $633 |
| Synergy Health Network | WorkersComp | $633 |
| Amerigroup | MCD | $1,395 |
| NHC Advantage | MGMCR | $1,978 |
| Pruitt Health | MCR | $1,978 |
| Peach State | MGMCD | $2,082 |
| Wellcare | MCD | $2,082 |
| Memorial Health Plan | EMPLOYEEPLAN | $2,290 |
| United | OptionsPPO | $2,572 |
| Americas 1st Choice | MCR | $2,915 |
| Leavitt Risk Partners | COMM | $3,123 |
| United | GlobalBenefitPlan | $4,685 |
| Dodge County Hospital | COMM | $5,206 |
| Aetna | NAP | $5,740 |
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