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MRI lower back without contrast at Memorial Hospital of South Bend. CPT 72148.

What Memorial Hospital of South Bend publishes for this service, straight from its standard-charges file, last updated January 1, 2026.

Outpatient / ER

$1,321cash price (self-pay)
$2,032list price
$136–$2,032range insurers pay
Insurance planNegotiated rate
McLaren | MI Medicaid$136
UHC | MI Medicaid$136
Anthem | Exchange$253
Anthem | Medicare Advantage$253
Humana | Medicare Advantage$253
PACE | Medicare$253
Caresource | Exchange$405
Devoted Healthcare | Medicare Advantage$406
Anthem | Commercial (excludes Granger)$409
Anthem | HealthSync$409
Anthem | IN Medicaid HCC$458
Anthem | IN Medicaid HHW$458
Anthem | IN Medicaid HIP$458
Anthem | Pathways for Aging$458
Caresource | IN Medicaid HHW$458
Caresource | IN Medicaid HIP$458
Humana | Pathways for Aging$458
MHS | IN Medicaid HCC$458
MHS | IN Medicaid HHW$458
MHS | IN Medicaid HIP$458
MdWise | IN Medicaid HHW$458
MdWise | IN Medicaid HIP$458
UHC | IN Medicaid HCC$458
Anthem | Workers Compensation$481
Aetna | Medicare Advantage$914
Anthem | Commercial (Granger)$1,164
CHA | Employer Group 4$1,219
Immergrun | Commercial$1,219
MHS | Exchange$1,321
Cigna | OAP$1,422

Inpatient

$1,321cash price (self-pay)
$2,032list price
$406–$1,666range insurers pay
Insurance planNegotiated rate
Devoted Healthcare | Medicare Advantage$406
Multiplan | Commercial$1,321
Cigna | OAP$1,422
UHC | Commercial$1,467
Humana | Commercial$1,483
Aetna | Commercial$1,496
CHA | Employer Group 5$1,524
CHA | Employer Group 6$1,626
Cigna BH | Commercial$1,626
Immergrun | Commercial$1,626
Plain Church | Commercial$1,626
Cigna | PPO$1,666
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All common services at Memorial Hospital of South Bend