MRI lower back without contrast at IU Health White Memorial Hospital. CPT 72148.
What IU Health White Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$404cash price (self-pay)
$1,296list price
$311–$1,192range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Self-Pay | Other - Self-Pay | $404 |
| Managed Health Services | All Government Medicaid HIP | $458 |
| Caresource | All Government Medicaid HIP | $458 |
| Managed Health Services | All Government Medicaid | $458 |
| Caresource | All Managed Medicaid | $458 |
| United Healthcare | All Managed Medicaid | $458 |
| Elevance Health | All Managed Medicaid | $458 |
| Elevance Health | All Government Medicaid HIP | $458 |
| Suburban Health Organization | PPO - Direct | $680 |
| Suburban Health Organization | PPO - Witham Health Services | $680 |
| Aetna | PPO - NAP | $752 |
| Aetna | PPO - First Health | $752 |
| Deaconess Health System | All Managed Care | $752 |
| Community Health Direct | HMO - LaPorte Regional Plans | $765 |
| Parkview Health | HMO - Employee Plans | $801 |
| Cigna | HMO | $816 |
| Cigna | PPO | $816 |
| Cigna | HMO - Open Access | $816 |
| Cigna | HMO/POS - Arnett Hospital Plans | $816 |
| Lutheran Health Network | All Managed Care | $907 |
| Sagamore Health Network/Cigna | PPO - NON-DRG | $925 |
| Aetna | POS - Cox Medical Plans | $925 |
| SIHO Insurance Services | HMO/POS Plans | $925 |
| Aetna | PPO - IN Preferred | $925 |
| Elevance Health | All IUHP Employee Plans | $925 |
| Elevance Health | All PPO | $925 |
| Elevance Health | All Traditional Plans | $925 |
| Elevance Health | All HMO/POS | $925 |
| Aetna | PPO/POS | $925 |
| Encore Health Network | PPO | $925 |
Inpatient
$618cash price (self-pay)
$1,981list price
$618–$1,823range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Self-Pay | Other - Self-Pay | $618 |
| Encore Health Network | PPO | $733 |
| SIHO Insurance Services | PPO - Union Health | $812 |
| Elevance Health | All HMO/POS | $934 |
| Elevance Health | All IUHP Employee Plans | $1,006 |
| Elevance Health | All PPO | $1,006 |
| Indiana Health Network (IHN) | All Managed Care | $1,031 |
| Suburban Health Organization | PPO - Direct | $1,040 |
| Suburban Health Organization | PPO - Witham Health Services | $1,040 |
| Aetna | HMO - Coventry Plans | $1,060 |
| Aetna | PPO/POS | $1,060 |
| Aetna | PPO - IN Preferred | $1,066 |
| Aetna | POS - Cox Medical Plans | $1,066 |
| United Healthcare | All Managed Care | $1,139 |
| Aetna | PPO - NAP | $1,149 |
| Aetna | PPO - First Health | $1,149 |
| Community Health Direct | HMO - LaPorte Regional Plans | $1,169 |
| Parkview Health | HMO - Employee Plans | $1,224 |
| Unified Group Services | HMO | $1,228 |
| Sagamore Health Network/Cigna | PPO - NON-DRG | $1,248 |
| Cigna | HMO/POS - Arnett Hospital Plans | $1,248 |
| Cigna | HMO - Open Access | $1,248 |
| Cigna | HMO | $1,248 |
| Cigna | PPO | $1,248 |
| Sagamore Health Network/Cigna | PPO - DRG Plans | $1,248 |
| Elevance Health | All Traditional Plans | $1,365 |
| Lutheran Health Network | All Managed Care | $1,387 |
| Parkview Health | EPO | $1,428 |
| Lutheran Preferred | All PPO Plans | $1,585 |
| Parkview Health | PPO | $1,632 |
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