MRI lower back without contrast at Gundersen St. Elizabeth Hospital and Clinics. CPT 72148.
What Gundersen St. Elizabeth Hospital and Clinics publishes for this service, straight from its standard-charges file, last updated June 27, 2026.
Outpatient / ER
$2,140cash price (self-pay)
$3,514list price
$149–$3,373range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Medicaid | $149 |
| Group Health of South Central | Medicaid HMO | $149 |
| Iowa Total Care | Medicaid | $149 |
| Managed Health Service | Managed Medicaid | $149 |
| Quartz | Medicaid_Badgercare | $149 |
| South County | Managed Medicaid | $149 |
| Medica | AccessAbilty Solution | $735 |
| Medica | Minnesota Care | $735 |
| Bcbsmn | Mhcp | $870 |
| Alliance | Premier/All Products | $975 |
| Alliance | Comprehensive/All Products | $975 |
| Quartz | All Products | $1,486 |
| Quartz | All Other Self Funded | $1,546 |
| Quartz | Self Funded | $1,652 |
| Quartz | Level Funded | $1,704 |
| Health Partners | Medicaid HMO | $1,757 |
| Aetna | Medicare Advantage | $1,898 |
| Quartz | Fully Insured | $1,915 |
| Medica | Medicare Advantage | $1,933 |
| Health Partners | Medicare Cost | $2,108 |
| Anthem | Medicare HMO/PPO | $2,284 |
| Health Partners | Medicare Advantage | $2,284 |
| Humana | Medicare Advantage | $2,284 |
| Quartz | Medicare Advantage | $2,284 |
| South County | Managed Medicare | $2,284 |
| UCARE | Dually Eligible | $2,284 |
| UCARE | Non-Dually Eligible | $2,284 |
| BCBSMN | All Products | $2,419 |
| Medica | All Products | $2,777 |
| Group Health of South Central | All Products | $2,811 |
Inpatient
$2,140cash price (self-pay)
$3,514list price
$870–$3,373range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Quartz | All Other Self Funded | $2,070 |
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All common services at Gundersen St. Elizabeth Hospital and Clinics