MRI lower back without contrast at IU Health Jay Hospital. CPT 72148.
What IU Health Jay Hospital publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$580cash price (self-pay)
$1,296list price
$458–$1,264range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Managed Health Services | All Government Medicaid | $458 |
| Elevance Health | All Managed Medicaid | $458 |
| United Healthcare | All Managed Medicaid | $458 |
| Caresource | All Managed Medicaid | $458 |
| Managed Health Services | All Government Medicaid HIP | $458 |
| Elevance Health | All Government Medicaid HIP | $458 |
| Caresource | All Government Medicaid HIP | $458 |
| Self-Pay | Other - Self-Pay | $580 |
| Suburban Health Organization | PPO - Witham Health Services | $680 |
| Deaconess Health System | All Managed Care | $752 |
| Community Health Direct | HMO - LaPorte Regional Plans | $765 |
| Parkview Health | HMO - Employee Plans | $801 |
| Lutheran Health Network | All Managed Care | $907 |
| Elevance Health | All PPO | $925 |
| Elevance Health | All Traditional Plans | $925 |
| Elevance Health | All HMO/POS | $925 |
| Elevance Health | All IUHP Employee Plans | $925 |
| Sagamore Health Network/Cigna | PPO - NON-DRG | $925 |
| Sagamore Health Network/Cigna | PPO - DRG Plans | $925 |
| Encore Health Network | PPO/HMO/EPO - Combined/Encircle | $925 |
| Encore Health Network | PPO | $925 |
| Cigna | HMO/POS - Arnett Hospital Plans | $925 |
| SIHO Insurance Services | All PPO Plans | $925 |
| Aetna | POS - Cox Medical Plans | $925 |
| Cigna | PPO | $925 |
| Aetna | PPO/POS | $925 |
| SIHO Insurance Services | HMO/POS Plans | $925 |
| Cigna | HMO | $925 |
| Aetna | PPO - IN Preferred | $925 |
| Aetna | HMO - Coventry Plans | $925 |
Inpatient
$886cash price (self-pay)
$1,981list price
$698–$1,981range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Elevance Health | All HMO/POS | $698 |
| Elevance Health | All PPO | $698 |
| Elevance Health | All IUHP Employee Plans | $709 |
| Elevance Health | All Traditional Plans | $739 |
| Self-Pay | Other - Self-Pay | $886 |
| Suburban Health Organization | PPO - Witham Health Services | $1,040 |
| Suburban Health Organization | PPO - Direct | $1,040 |
| Community Health Direct | HMO - LaPorte Regional Plans | $1,169 |
| Parkview Health | HMO - Employee Plans | $1,224 |
| Unified Group Services | HMO | $1,228 |
| Aetna | POS - Cox Medical Plans | $1,246 |
| Aetna | PPO - IN Preferred | $1,246 |
| Cigna | PPO - New Business | $1,248 |
| Lutheran Health Network | All Managed Care | $1,387 |
| United Healthcare | All Managed Care | $1,406 |
| Parkview Health | EPO | $1,428 |
| Aetna | PPO - NAP | $1,446 |
| Aetna | PPO - First Health | $1,446 |
| Aetna | PPO/POS | $1,577 |
| Aetna | HMO - Coventry Plans | $1,577 |
| Lutheran Preferred | All PPO Plans | $1,585 |
| Parkview Health | PPO | $1,632 |
| Multiplan | PPO - PHCS Private Healthcare Plans | $1,684 |
| Encore Health Network | PPO | $1,725 |
| Indiana Health Network (IHN) | All Managed Care | $1,749 |
| Sagamore Health Network/Cigna | PPO - DRG Plans | $1,751 |
| Cigna | HMO | $1,751 |
| Sagamore Health Network/Cigna | PPO - NON-DRG | $1,751 |
| Cigna | HMO/POS - Arnett Hospital Plans | $1,751 |
| Cigna | PPO | $1,751 |
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