MRI lower back without contrast at Southeast Iowa Regional Medical Center West Burlington. CPT 72148.

What Southeast Iowa Regional Medical Center West Burlington publishes for this service, straight from its standard-charges file, last updated June 11, 2026.

Outpatient / ER

—cash price (self-pay)

$512list price

$54.36–$3,229range insurers pay

Insurance plan	Negotiated rate
American Healthplan of Iowa - Midlevel \| MEDICARE ADV.	$75.46
Humana \| MEDICARE ADV.	$93.36
American Healthplan of Iowa - MD \| MEDICARE ADV.	$97.78
Aetna \| FIRST HEALTH	$103
United Healthcare \| ALL PRODUCTS	$140
Midlands Choice \| ALL PRODUCTS	$207
Medicaid - Nurse Practitioner \| MANAGED MEDICAID	$210
Medicaid - Physician Assistant \| MANAGED MEDICAID	$214
Wellmark Blue Cross - Anesthesiology \| PPO	$217
Wellmark Blue Cross - Pathologist \| PPO	$217
Wellmark Blue Cross - Physician \| HMO	$217
Wellmark Blue Cross - Physician Assistant \| HMO	$217
Wellmark Blue Cross - Physician Assistant \| PPO	$217
Plain Church \| ALL PRODUCTS	$235
Wellmark Blue Cross - Physician \| PPO	$255
Absolute Solutions \| ALL PRODUCTS	$325
First Agency \| ALL PRODUCTS	$325
Multiplan \| ALL PRODUCTS	$325
Henderson County \| ALL PRODUCTS	$343
Wellmark Blue Cross \| HMO	$765
Wellmark Blue Cross \| PPO	$840
Midlands Choice \| All Products	$984
Wellpoint (Amerigroup) \| Managed Medicaid	$1,944
Immugrun \| All Products	$2,187
Brighton Amish Church \| All Products	$2,257
Plain Church \| All Products	$2,257
6 Degree \| All Products	$2,778
Geha \| PPO	$3,229

Inpatient

—cash price (self-pay)

$3,472list price

$1,944–$3,229range insurers pay

Insurance plan	Negotiated rate
Midlands Choice \| All Products	$3,125

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All common services at Southeast Iowa Regional Medical Center West Burlington