MRI lower back without contrast at INDIANA ORTHOPAEDIC HOSPITAL LLC Northwest. CPT 72148.
What INDIANA ORTHOPAEDIC HOSPITAL LLC Northwest publishes for this service, straight from its standard-charges file, last updated June 10, 2026.
Outpatient / ER
$568cash price (self-pay)
$3,967list price
$379–$3,452range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aarp | Aarp | $379 |
| Aarp Medicare Complete | Aarp Medicare Complete | $379 |
| Aarp Medicare Complete Aarp Medicare Complete Via United | Aarp Medica | $379 |
| Aarp Medicare Complete/Wellmed Wellmed As Payor | Aarp Medicare Comple | $379 |
| Aarp Medicare Supplement Plan | Aarp Medicare Supplement Plan | $379 |
| Aarp Medicarecomplete Choice PPO | Aarp Medicarecomplete Choice PPO | $379 |
| Aarp Po 740819 | Aarp Po 740819 | $379 |
| Aarp Select Aarp Select Plan C & F | Aarp Select Aarp Select Plan C | $379 |
| Aarp Supplemental | Aarp Supplemental | $379 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $379 |
| Aetna Medicare HMO Aetna Golden Medicare Choice | Aetna Medicare HMO A | $379 |
| Aetna Medicare PPO Aetna Medicare | Aetna Medicare PPO Aetna Medicare | $379 |
| Aetna Medicare PPO Esa Aetna Medicare With Esa On Id Card | Aetna Medi | $379 |
| Aetna Medicare Uaw Esa Uaw Members With Esa On Id Card | Aetna Medicar | $379 |
| Aetna Medicare Uaw PPO Uwa Members With PPO Plan | Aetna Medicare Uaw | $379 |
| Aetna Senior Supplemental | Aetna Senior Supplemental | $379 |
| Aetna Senior Supplemental Insurance | Aetna Senior Supplemental Insura | $379 |
| Allwell - Mhs Mhs - Allwell | Allwell - Mhs Mhs - Allwell | $379 |
| Anthem Healthy Indiana Health Indiana Plan - Anthem | Anthem Healthy I | $379 |
| Anthem Hhw - St. Francis St Francis Only | Anthem Hhw - St. Francis St | $379 |
| Anthem Hip - St. Francis St. Francis Only | Anthem Hip - St. Francis S | $379 |
| Ambetter | Ambetter | $663 |
| Ambetter - Mhs Ambetter | Ambetter - Mhs Ambetter | $663 |
| Ambetter Mhs | Ambetter Mhs | $663 |
| Anthem HMO Blue Preferred | Anthem HMO Blue Preferred | $732 |
| Anthem BCBS Hpn Blue High Performance Network (Hpn) | Anthem BCBS Hp | $771 |
| Anthem BCBS Anthem Enhanced Choice (Prefix E7b) | Anthem BCBS Anthem E | $771 |
| Anthem Blue Cross And Blue Shield | Anthem Blue Cross And Blue Shield | $771 |
| Anthem Geoblue BCBS International Plan | Anthem Geoblue BCBS Internati | $771 |
| All Savers | All Savers | $820 |
Inpatient
$18,085cash price (self-pay)
$40,901list price
$2,431–$40,901range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Aetna | $2,947 |
| Aetna Open Access | Aetna Open Access | $2,947 |
| Aetna Apcn Apcn - Aetna Premium Care Network | Aetna Apcn Apcn - Aet | $2,947 |
| Aetna HMO Aetna Choice POS | Aetna HMO Aetna Choice POS | $2,947 |
| Aetna HMO Aetna Select | Aetna HMO Aetna Select | $2,947 |
| Aetna HMO Managed Choice HMO | Aetna HMO Managed Choice HMO | $2,947 |
| Aetna PPO Nap (National Advantage Program) | Aetna PPO Nap (National A | $2,947 |
| Aetna PPO Open Choice PPO | Aetna PPO Open Choice PPO | $2,947 |
| Aetna PPO Signature Administrators | Aetna PPO Signature Administrator | $2,947 |
| Aarp | Aarp | $12,057 |
| Aarp Medicare Complete | Aarp Medicare Complete | $12,057 |
| Aarp Medicare Complete Aarp Medicare Complete Via United | Aarp Medica | $12,057 |
| Aarp Medicare Complete/Wellmed Wellmed As Payor | Aarp Medicare Comple | $12,057 |
| Aarp Medicare Supplement Plan | Aarp Medicare Supplement Plan | $12,057 |
| Aarp Medicarecomplete Choice PPO | Aarp Medicarecomplete Choice PPO | $12,057 |
| Aarp Po 740819 | Aarp Po 740819 | $12,057 |
| Aarp Select Aarp Select Plan C & F | Aarp Select Aarp Select Plan C | $12,057 |
| Aarp Supplemental | Aarp Supplemental | $12,057 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $12,057 |
| Aetna Medicare HMO Aetna Golden Medicare Choice | Aetna Medicare HMO A | $12,057 |
| Aetna Medicare PPO Aetna Medicare | Aetna Medicare PPO Aetna Medicare | $12,057 |
| Aetna Medicare PPO Esa Aetna Medicare With Esa On Id Card | Aetna Medi | $12,057 |
| Aetna Medicare Uaw Esa Uaw Members With Esa On Id Card | Aetna Medicar | $12,057 |
| Aetna Medicare Uaw PPO Uwa Members With PPO Plan | Aetna Medicare Uaw | $12,057 |
| Aetna Senior Supplemental | Aetna Senior Supplemental | $12,057 |
| Aetna Senior Supplemental Insurance | Aetna Senior Supplemental Insura | $12,057 |
| Allwell - Mhs Mhs - Allwell | Allwell - Mhs Mhs - Allwell | $12,057 |
| Anthem Healthy Indiana Health Indiana Plan - Anthem | Anthem Healthy I | $12,057 |
| Anthem Hhw - St. Francis St Francis Only | Anthem Hhw - St. Francis St | $12,057 |
| Anthem Hip - St. Francis St. Francis Only | Anthem Hip - St. Francis S | $12,057 |
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All common services at INDIANA ORTHOPAEDIC HOSPITAL LLC Northwest