MRI lower back without contrast at Holland Hospital. CPT 72148.
What Holland Hospital publishes for this service, straight from its standard-charges file, last updated September 21, 2026.
Outpatient / ER
$1,103cash price (self-pay)
$1,838list price
$223–$3,768range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Existing Bus - All Other Plans | Aetna Existing Bus - All Other | $223 |
| Aetna New Bus | Aetna New Bus | $223 |
| Life Circles-All Plans | Life Circles-All Plans | $226 |
| Health Alliance Mcr Adv | Health Alliance Mcr Adv | $238 |
| Va Ccn - All Plans | Va Ccn - All Plans | $238 |
| Ph Mcr Adv | Ph Mcr Adv | $238 |
| Aetna Mcr Adv | Aetna Mcr Adv | $245 |
| Longevity Health Plan-All Plans | Longevity Health Plan-All Plans | $257 |
| BCBS - All Plans | BCBS - All Plans | $313 |
| Cofinity -All Plans | Cofinity -All Plans | $375 |
| Health Alliance HMO | Health Alliance HMO | $539 |
| Asr - All Plans | Asr - All Plans | $563 |
| Health Alliance Ahl - All Other Plans | Health Alliance Ahl - All Othe | $563 |
| Molina Mcaid - All Plans | Molina Mcaid - All Plans | $588 |
| Ph Mcaid | Ph Mcaid | $588 |
| Cigna - All Plans | Cigna - All Plans | $669 |
| Sisco Epi | Sisco Epi | $738 |
| Sisco-All Other Plans | Sisco-All Other Plans | $738 |
| Priority Health - All Other Plans | Priority Health - All Other Plans | $741 |
| Multiplan - All Plans | Multiplan - All Plans | $1,599 |
| Usa Managed Care-All Plans | Usa Managed Care-All Plans | $1,654 |
| Benefit Source Inc-All Plans | Benefit Source Inc-All Plans | $1,654 |
| First Health-All Plans | First Health-All Plans | $1,654 |
| Integrated Health Plans-All Plans | Integrated Health Plans-All Plans | $1,746 |
| UHC Mcaid | UHC Mcaid | $1,838 |
| UHC Mcr Adv | UHC Mcr Adv | $1,838 |
| Nomi Health - All Plans | Nomi Health - All Plans | $3,768 |
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