MRI lower back without contrast at Memorial Hospital and Manor. CPT 72148.
What Memorial Hospital and Manor publishes for this service, straight from its standard-charges file, last updated May 1, 2026.
Outpatient / ER
$1,551cash price (self-pay)
$2,215list price
$191–$2,104range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Tricare_plan | Medicare | $191 |
| Aetna_medicare_plan | Medicare | $205 |
| Humana_medicare_plan | Medicare | $205 |
| Medicare_plan | Medicare | $205 |
| Uhc_medicare_plan | Medicare | $205 |
| Wellcare_plan | Medicare | $205 |
| Ambetter_plan | Medicare | $266 |
| Alliant_plan | Medicare | $328 |
| Tnga_plan | Commercial | $450 |
| Amerigroup_plan | Medicaid | $1,395 |
| Medicaid__plan | Medicaid | $1,395 |
| Peach_state_health_plan_plan | Medicaid | $1,395 |
| Caresource_plan | Medicaid | $1,464 |
| Anthem_plan | Commercial | $1,710 |
| Humana_commercial_plan | Commercial | $1,728 |
| Aetna_plan | Commercial | $1,750 |
| Uhc_plan | Commercial | $1,750 |
| Humana_choice_care_plan | Commercial | $1,772 |
| Novanet_plan | Commercial | $1,772 |
| Cigna_plan | Commercial | $1,838 |
| Private_healthcare_systems_plan | Commercial | $1,883 |
| Aetna_medical_rental_plan | Commercial | $1,994 |
| Multiplan_plan | Commercial | $1,994 |
| Corvel_plan | Commercial | $2,104 |
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