MRI lower back without contrast at Henry Ford Jackson Hospital. CPT 72148.
What Henry Ford Jackson Hospital publishes for this service, straight from its standard-charges file, last updated June 28, 2026.
Outpatient / ER
$92.85cash price (self-pay)
$275list price
$43.67–$2,880range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Humana Military | Tricare | $105 |
| Blue Cross | Blue Cross Complete | $127 |
| HAP | HAP Caresource Medicaid | $127 |
| McLaren | Medicaid HMO | $127 |
| Meridian | Medicaid HMO | $127 |
| Priority Health | Medicaid HMO | $127 |
| Aetna Better Health | Medicaid HMO | $134 |
| Molina | Medicaid HMO | $135 |
| Veterans Evaluation Services | All Products | $214 |
| Aetna | Medicare Advantage | $239 |
| Blue Cross | Medicare Plus Blue | $239 |
| Blue Cross | BCN Advantage | $239 |
| Cascade Thome Pace | All Products | $239 |
| Humana | Medicare Advantage | $239 |
| McLaren | Medicare Advantage | $239 |
| Molina | Dual MI Coordinated Health | $239 |
| Priority Health | Dual Premier_HIDE-SNP | $239 |
| Priority Health | Medicare Advantage | $239 |
| United Healthcare | VACCN | $239 |
| WellCare | Wellcare Meridian Dual Align (HMO D-SNP) | $239 |
| Blue Cross | BCBSM Commercial | $239 |
| HAP | HAP Dual Products | $241 |
| HAP | Medicare Advantage | $241 |
| Meridian | Ambetter From Meridian | $263 |
| HAP | Commercial | $279 |
| HAP | Henry Ford Select -HPN commercial | $287 |
| Nomi | All Products | $296 |
| Bcn | HMO | $367 |
| Blue Cross | BCN Commercial | $367 |
| Aetna | Commercial | $488 |
Inpatient
—cash price (self-pay)
$3,200list price
$1,607–$2,880range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare | UHC Commercial | $2,358 |
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