MRI lower back without contrast at Fairview Hospital. CPT 72148.
What Fairview Hospital publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$2,312cash price (self-pay)
$2,998list price
$196–$3,384range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Other Government | Tri Tricare | $556 |
| Medicare | MCR Traditional Medicare | $565 |
| Medicare | MCRManaged Medicare HMO | $565 |
| Fallon | MCRManaged Fallon Medicare Advantage | $570 |
| Fallon | MCRManaged Fallon Medicare SCO | $572 |
| Hospice | Comm Hospice | $574 |
| Other Government | MCR Miscellaneous | $574 |
| Other Government | MCRManaged USA Family | $574 |
| Other Government | MCRManaged VA | $574 |
| United Healthcare | Oth United VACCN | $574 |
| Blue Cross | MCRManaged Blue Cross VT Medicare HMO | $580 |
| Health New England | MCRManaged HNE Medicare Advantage | $580 |
| CommCare Alliance | MCRManaged CCA One Care | $583 |
| Point32Health | Comm Tufts QHPSUB (Network) | $830 |
| Point32Health | MCDManaged Tufts (Network) | $830 |
| Comm Fallon QHP | Comm Fallon QHP | $898 |
| Comm HNE HMO | Comm HNE HMO | $991 |
| Unicare | Comm Wellpoint (Unicare) | $1,032 |
| Health New England | Comm HNE | $1,049 |
| Comm HNE PPO | Comm HNE PPO | $1,053 |
| Aetna | Comm Aetna | $1,075 |
| Fallon | MCDManaged Fallon Medicaid ACO | $1,230 |
| Allways NHP | Comm NHP | $1,940 |
| United Healthcare | Comm United BH | $1,949 |
| Point32Health | Comm Tufts QHPNONSUB (Network) | $2,015 |
| Blue Cross | Comm Blue Cross VT PPO | $2,317 |
| Point32Health | Comm Tufts | $2,375 |
| United Healthcare | Comm UnitedHealthcare | $2,578 |
| Capital District Physicians' Health Plan | Comm CDPHP | $2,698 |
| Cigna | Comm Cigna Carelink | $2,698 |
Inpatient
$3,384cash price (self-pay)
$3,562list price
$2,013–$3,384range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Point32Health | Comm Tufts QHPSUB (Network) | $2,013 |
| Point32Health | MCDManaged Tufts (Network) | $2,013 |
| Workers Comp | WC Workers Comp | $2,271 |
| Allways NHP | Comm NHP | $2,305 |
| Point32Health | Comm Tufts QHPNONSUB (Network) | $2,308 |
| United Healthcare | Comm United BH | $2,315 |
| Blue Cross | Comm Blue Cross VT PPO | $2,565 |
| Aetna | Comm Aetna | $2,689 |
| Point32Health | Comm Tufts | $2,821 |
| United Healthcare | Comm UnitedHealthcare | $3,063 |
| Capital District Physicians' Health Plan | Comm CDPHP | $3,206 |
| MVP | Comm MVP | $3,206 |
| Oxford | Comm Oxford | $3,206 |
| Connecticare | Comm Connecticare | $3,384 |
| Consolidated Health Plans | Comm Consolidated Health | $3,384 |
| First Health | Comm First Health | $3,384 |
| Point32Health | Comm Harvard | $3,384 |
| Other Commercial | Comm Other | $3,384 |
| PHCS | Comm PHCS | $3,384 |
| Self Pay | Comm Self Pay | $3,384 |
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