MRI lower back without contrast at Northwest Health - Porter. CPT 72148.
What Northwest Health - Porter publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,597cash price (self-pay)
$5,913list price
$222–$4,967range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Veterans Eval Services | Veterans Eval Services | $222 |
| NODE Tricare | NODE Tricare | $240 |
| Align Network | Align Network | $404 |
| Anthem | Anthem IN Medicaid | $458 |
| CareSource | Caresource HHW IN Medicaid | $458 |
| CareSource | CareSource IN HIP | $458 |
| Humana PathWays IN Medicaid | Humana PathWays IN Medicaid | $458 |
| Indiana Medicaid | IN Medicaid | $458 |
| Indiana Medicaid Non Par | IN Medicaid Non Par | $458 |
| MHS | MHS HCC IN Medicaid | $458 |
| Managed Health Services | MHS HHW IN Medicaid | $458 |
| Managed Health Services | MHS IN HIP | $458 |
| UHC | UHC HCC IN Medicaid | $458 |
| UHC PathWays IN Medicaid | UHC PathWays IN Medicaid | $458 |
| One Call | One Call Care Diagnostics WC | $500 |
| Lutheran Preferred | Lutheran Preferred Exclusive Plus | $690 |
| Lutheran Preferred | Lutheran Preferred Fixed 2 | $690 |
| Encore PPO | Encore Combined PPO | $1,260 |
| Lutheran Preferred CHS Employees | Lutheran Preferred CHS Employees | $1,419 |
| Aetna | Aetna HMO/POS | $1,470 |
| Self Pay | Self Pay | $1,597 |
| Cigna | Cigna ALL | $1,644 |
| United Healthcare | UHC APA | $1,817 |
| United Healthcare | UHC PPO | $2,179 |
| Physicians Health Plan | PHP Options | $2,266 |
| PHP Freedom | PHP Freedom Network | $2,443 |
| First Health Coventry | First Health | $2,553 |
| Sagamore Health Network | Sagamore Indiana Financial | $2,614 |
| Aetna | Aetna PPO | $2,856 |
| Sagamore Health Network | Sagamore Anthem Groups | $2,909 |
Inpatient
$2,129cash price (self-pay)
$5,913list price
$1,419–$4,967range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Lutheran Preferred CHS Employees | Lutheran Preferred CHS Employees | $1,419 |
| Cigna | Cigna ALL | $1,644 |
| Self Pay | Self Pay | $2,129 |
| Physicians Health Plan | PHP Options | $2,266 |
| PHP Freedom | PHP Freedom Network | $2,443 |
| Sagamore Health Network | Sagamore Indiana Financial | $2,614 |
| Sagamore Health Network | Sagamore Anthem Groups | $2,909 |
| Aetna | Aetna PPO | $2,998 |
| Sagamore Health Network | Sagamore Select Plus | $3,501 |
| Lutheran Preferred | Lutheran Preferred Choice | $3,548 |
| Southeastem Indiana Health Operations | SIHO Outside Counties | $4,139 |
| Prime Health | PRIME HEALTH SERVICES | $4,435 |
| Prime Health | Prime Health Services Auto | $4,435 |
| Southeastem Indiana Health Operations | SIHO Inside Counties | $4,435 |
| Encore Health | Encore Health PPO | $4,730 |
| Multiplan/PHCS | Multiplan Complementary | $4,967 |
| Multiplan/PHCS | PHCS Savility Primary Network | $4,967 |
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