MRI lower back without contrast at Jacksonville Memorial Hospital. CPT 72148.
What Jacksonville Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 17, 2026.
Outpatient / ER
$5,540cash price (self-pay)
$5,540list price
$15.66–$5,540range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Medicaid | Illinois Medicaid | $473 |
| Molina HealthCare | Molina Medicaid | $473 |
| Blue Cross Blue Shield | Blue Cross Community MMAI/Dual Eligible | $490 |
| Coventry | Coventry Advantra Medicare Advantage HMO | $525 |
| Health Alliance | Health Alliance Medicare Advantage | $525 |
| Humana | Humana/ChoiceCare Medicare Advantage PPO/HMO | $525 |
| Medicare | Medicare | $525 |
| United HealthCare | United HealthCare Medicare Advantage | $552 |
| Tricare | Tricare | $594 |
| Commercial Workers Compensation | Commercial Workers Compensation | $839 |
| WellCare Medicare Advantage PPO | WellCare Medicare Advantage PPO | $872 |
| UHC Va Ccn | UHC Va Ccn | $886 |
| Corvel/CorCare | Corvel/CorCare | $1,500 |
| Illinois Workers Compensation | Illinois Workers Compensation | $1,658 |
| Health Alliance MH Employee plan | Health Alliance MH Employee plan | $2,548 |
| Health Alliance | Health Alliance Fully Insured/Self Funded/ACA | $2,751 |
| Healthlink | Healthlink HMO | $2,932 |
| 6 Degrees Health | 6 Degrees Health | $3,324 |
| Hope Trust | Hope Trust | $3,324 |
| Hst | Hst | $3,324 |
| Cigna | Cigna | $3,839 |
| United Healthcare | United Healthcare PPO | $3,989 |
| Aetna | Aetna PPO | $4,152 |
| Current Health Network | Current Health Network | $4,155 |
| Humana/ChoiceCare | Humana/ChoiceCare | $4,726 |
| PHCS/Multiplan | PHCS/Multiplan PPO | $4,986 |
| Hfn | Hfn PPO | $5,263 |
| HFN | HFN Workers Compensation | $5,263 |
| Blue Cross Blue Shield | BCBS PPO/HMO/Employee | $5,540 |
| Liability | Liability | $5,540 |
Inpatient
$5,540cash price (self-pay)
$5,540list price
$2,548–$5,540range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Alliance MH Employee plan | Health Alliance MH Employee plan | $2,548 |
| Current Health Network | Current Health Network | $3,047 |
| 6 Degrees Health | 6 Degrees Health | $3,324 |
| Hope Trust | Hope Trust | $3,324 |
| Hst | Hst | $3,324 |
| Cigna | Cigna | $3,839 |
| Aetna | Aetna PPO | $3,872 |
| Humana/ChoiceCare | Humana/ChoiceCare | $4,726 |
| Hfn | Hfn PPO | $5,263 |
| HFN | HFN Workers Compensation | $5,263 |
| Blue Cross Blue Shield | BCBS PPO/HMO/Employee | $5,540 |
| Liability | Liability | $5,540 |
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