MRI lower back without contrast at Norton Clark Hospital. CPT 72148.
What Norton Clark Hospital publishes for this service, straight from its standard-charges file, last updated June 3, 2026.
Outpatient / ER
$578cash price (self-pay)
$4,130list price
$117–$3,614range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Managed Health Services (MHS) Hoosier Healthwise (HHW) | Managed Medic | $117 |
| Humana | Managed Medicaid | $117 |
| CareSource Indiana Healthy Indiana Plan (HIP) | Managed Medicaid | $117 |
| Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $117 |
| Anthem Blue Cross Blue Shield | Managed Medicaid | $117 |
| United Healthcare | Managed Medicaid | $121 |
| CareSource Indiana Hoosier Healthwise (HHW) | Managed Medicaid | $121 |
| Mdwise Hoosier Healthwise (HHW) | Managed Medicaid | $123 |
| Molina Healthcare of Indiana | Managed Medicaid | $124 |
| Managed Health Services (MHS) Healthy Indiana Plan (HIP) | Managed Med | $253 |
| Anthem Blue Cross Blue Shield | Medicare Advantage | $253 |
| United Healthcare | VACCN | $253 |
| MDwise Health Indiana Plan (HIP) | Managed Medicaid | $253 |
| Molina Healthcare of Indiana | Dual Medicare-Medicaid | $261 |
| Molina Healthcare of Indiana | Medicare Advantage | $261 |
| CommuniCare Advantage | Medicare Advantage | $261 |
| Aetna | Medicare Advantage | $261 |
| Managed Health Services (MHS) | Medicare Advantage | $266 |
| Managed Health Services (MHS) | Commercial Exchange | $367 |
| Aetna | Commercial | $600 |
| United Healthcare | Commercial | $620 |
| Anthem Blue Cross Blue Shield | HMO/PPO/Traditional | $789 |
| Anthem Blue Cross Blue Shield of Indiana | Exchange/Pathway Essentials | $789 |
| Cigna | Commercial | $1,683 |
| Anthem Blue Cross Blue Shield | Medicare Select | $1,903 |
| PPOM | Commercial | $3,614 |
Inpatient
$578cash price (self-pay)
$4,130list price
$1,777–$3,614range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Blue Cross Blue Shield of Indiana | Exchange/Pathway Essentials | $1,777 |
| Anthem Blue Cross Blue Shield | HMO/PPO/Traditional | $1,777 |
| PPOM | Commercial | $3,614 |
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