MRI lower back without contrast at Mercy Hospital. CPT 72148.
What Mercy Hospital publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$153cash price (self-pay)
$153list price
$44.52–$2,416range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Tricare East Humana | Tricare | $128 |
| Tricare West Healthnet | Tricare | $128 |
| Rx Allwin | Medicare | $132 |
| Molina Medicare Advantage | Medicare | $132 |
| American Health Plan | Medicare | $132 |
| Hudson Headwaters Pace | Medicare | $132 |
| Perennial Advantage | Medicare | $132 |
| Prominence Medicare | Medicare | $132 |
| Carefirst Medicare Advantage | Medicare | $132 |
| Blue Cross - Or (Regence) Medicare Advantage | Medicare | $132 |
| Medstar Dc Healthy Family | Medicaid | $155 |
| Medstar Md Health Choice | Medicaid | $155 |
| Blue Cross - Id Medicaid Advantage | Medicaid | $155 |
| Moda Plus Medicaid Advantage | Medicaid | $155 |
| Wellcare Medicare | Wellcare Medicare Advantage | $195 |
| Tufts Medicare Advantage | Tufts Medicare Advantage | $195 |
| Aetna Medicare Advantage | Aetna Medicare Advantage | $195 |
| Health New England Medicare Advantage | Health New England Medicare Ad | $197 |
| Connecticare Vip Medicare Advantage | Connecticare Medicare Advantage | $200 |
| Wc Society | Workers Comp | $202 |
| Wc Ohio Bureau | Workers Comp | $202 |
| Wc Sedgwick | Workers Comp | $202 |
| Wc Travelers | Workers Comp | $202 |
| Wc Chubb | Workers Comp | $202 |
| Wc Comp One Admin C/O Manageability | Workers Comp | $202 |
| Wc Donegal Insurance Group | Workers Comp | $202 |
| Wc Great West Casualty | Workers Comp | $202 |
| Wc Paradigm | Workers Comp | $202 |
| Carepartners Of Connecticut Medicare Advantage | Carepartners Medicare | $204 |
| Fallon Health Medicare Advantage | Fallon Navicare Medicare Advantage | $221 |
Inpatient
$174cash price (self-pay)
$174list price
$44.52–$505range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Medicare Advantage | Medicare | $132 |
| Rx Allwin | Medicare | $132 |
| Rx Grane Grnmedd | Medicare | $132 |
| Rx Retiree Rx Care | Medicare | $132 |
| Rx Carelonrx Medicare | Medicare | $132 |
| Provider Partners Health Plan Of Indiana | Medicare | $132 |
| Sanford Health Plan Medicare Advantage | Medicare | $132 |
| Thome Pace | Medicare | $132 |
| Optum Medicare Transplant | Medicare | $132 |
| Humana Medicare Transplant | Medicare | $132 |
| Aetna Medicare Transplant | Medicare | $132 |
| Gold Kidney Medicare | Medicare | $132 |
| Gateway Health Plan | Medicare | $132 |
| Blue Shield - Id (Regence) Medicare Advantage | Medicare | $132 |
| Michigan Complete Health | Medicare | $132 |
| Mdwise | Medicaid | $155 |
| Mclaren Health Medicaid | Medicaid | $155 |
| Wc General Motors | Workers Comp | $202 |
| Rx Saif Opdp Wc | Workers Comp | $202 |
| Blue Cross - Va (Anthem) | BCBS HMO | $310 |
| Blue Cross - Id | BCBS HMO | $310 |
| Blue Cross - Hi | BCBS HMO | $310 |
| Blue Cross - Me (Anthem) | BCBS HMO | $310 |
| Blue Cross - La | BCBS HMO | $310 |
| Blue Cross - Ky (Anthem) | BCBS HMO | $310 |
| Blue Shield - Id (Regence) | BCBS HMO | $310 |
| Blue Cross - Nj (Horizon) | BCBS HMO | $310 |
| Blue Cross - Nh (Anthem) | BCBS HMO | $310 |
| Blue Cross - Nv (Anthem) | BCBS HMO | $310 |
| Blue Cross - Mt | BCBS HMO | $310 |
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