MRI lower back without contrast at Henry Ford Wyandotte Hospital:. CPT 72148.
What Henry Ford Wyandotte Hospital: publishes for this service, straight from its standard-charges file, last updated June 28, 2026.
Outpatient / ER
$96.17cash price (self-pay)
$275list price
$43.67–$1,899range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| ScriptGuideRX | All Products | $68.98 |
| Blue Cross | GM Connected Care | $100 |
| Humana Military | Tricare | $110 |
| HAP | HAP Caresource Medicaid | $127 |
| McLaren | Medicaid HMO | $127 |
| Meridian | Medicaid HMO | $127 |
| Priority Health | Medicaid HMO | $127 |
| Aetna Better Health | Medicaid HMO | $130 |
| Molina | Medicaid HMO | $134 |
| Blue Cross | BCBSM Commercial | $208 |
| Pace SE MI | Medicare Advantage | $226 |
| Amerihealth Caritas | Dual Products | $233 |
| Aetna | Medicare Advantage | $238 |
| Blue Cross | Medicare Plus Blue | $238 |
| Blue Cross | BCN Advantage | $238 |
| HAP | Medicare Advantage | $238 |
| HAP | HAP Dual Products | $238 |
| McLaren | Medicare Advantage | $238 |
| Molina | Dual MI Coordinated Health | $238 |
| Priority Health | Medicare Advantage | $238 |
| Priority Health | Dual Premier_HIDE-SNP | $238 |
| Trinity Health Plan | Medicare Advantage | $238 |
| United Healthcare | VACCN | $238 |
| United Healthcare | Erickson Advantage | $238 |
| Humana | Medicare Advantage | $240 |
| Nomi | All Products | $260 |
| Aetna | Dual Products | $262 |
| HAP | Henry Ford Select -HPN commercial | $285 |
| Blue Cross | BCBSM GM Connected Care | $292 |
| Bcn | HMO | $305 |
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