MRI lower back without contrast at Calais Community Hospital. CPT 72148.
What Calais Community Hospital publishes for this service, straight from its standard-charges file.
Outpatient / ER
$453cash price (self-pay)
$1,575list price
$29.00–$2,342range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Medicare Advantage | $239 |
| United Healthcare | Medicare Advantage | $239 |
| Humana | Commercial | $662 |
| Martins Point Generation | Commercial | $662 |
| Wellcare | HMO | $662 |
| Partners Direct Health | Commercial | $914 |
| Anthem | Commercial | $1,292 |
| Aetna | Commercial | $1,355 |
| United Healthcare | PPO | $1,386 |
| Cigna | Commercial | $1,434 |
| Harvard Pilgrim | Commercial | $1,449 |
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