MRI lower back without contrast at Stephens Memorial Hospital. CPT 72148.
What Stephens Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 9, 2025.
Outpatient / ER
$1,442cash price (self-pay)
$1,442list price
$69.85–$1,399range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | MHACO Government | $130 |
| Anthem | Medicare Advantage | $190 |
| Aetna | Medicare Advantage | $219 |
| United Healthcare | Medicare Advantage | $219 |
| Humana | Medicare Advantage | $219 |
| Wellcare | Medicare Advantage | $228 |
| Aetna | HMO/PPO | $260 |
| Aetna | MHACO Commercial | $269 |
| Multiplan | Commercial | $283 |
| United Healthcare | Commercial | $298 |
| Community Health Options | Commercial | $324 |
| Harvard Pilgrim Healthcare | Commercial | $379 |
| Harvard Pilgrim Healthcare | Maine's Choice | $379 |
| Anthem | HMO/POS/PPO Pathway Enhanced | $1,023 |
| Cigna | Commercial | $1,344 |
Inpatient
$1,442cash price (self-pay)
$1,442list price
$1,259–$1,399range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Harvard Pilgrim Healthcare | Maine's Choice | $1,259 |
| Aetna | HMO/PPO | $1,318 |
| Cigna | Commercial | $1,344 |
| Anthem | HMO/POS/PPO Pathway Enhanced | $1,348 |
| Multiplan | Commercial | $1,356 |
| Community Health Options | Commercial | $1,370 |
| United Healthcare | Commercial | $1,385 |
| Harvard Pilgrim Healthcare | Commercial | $1,399 |
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