MRI lower back without contrast at Advocate Good Samaritan Hospital. CPT 72148.
What Advocate Good Samaritan Hospital publishes for this service, straight from its standard-charges file, last updated November 4, 2025.
Outpatient / ER
$1,505cash price (self-pay)
$3,010list price
$365–$2,408range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Ambetter | Medicare Advantage | $365 |
| Molina | Medicare Advantage | $365 |
| Oscar Health HMO | Medicare Advantage | $378 |
| HSTechnology | Medicare Advantage | $484 |
| Cigna | Commercial | $1,096 |
| Cigna One Health | Commercial | $1,096 |
| Advocate Employee | Commercial | $1,186 |
| United Healthcare | HMO | $1,276 |
| United Healthcare Charter | Commercial | $1,276 |
| United Healthcare Core Navigate | Commercial | $1,276 |
| United Healthcare Nexus | Commercial | $1,276 |
| Blue Cross Blue Shield City of Chicago | Commercial | $1,556 |
| Aetna | Commercial | $1,613 |
| Blue Cross Blue Shield Choice | Commercial | $1,683 |
| Blue Cross Blue Shield | PPO | $1,772 |
| Blue Cross Blue Shield Blue Precision | Managed Care | $2,327 |
| Blue Cross Blue Shield | HMO | $2,372 |
| Multiplan | Commercial | $2,408 |
| Private Healthcare Systems | Commercial | $2,408 |
Inpatient
$1,505cash price (self-pay)
$3,010list price
$1,315–$2,408range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Advocate Employee | Commercial | $1,315 |
| Private Healthcare Systems | Commercial | $1,866 |
| Multiplan | Commercial | $2,408 |
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