MRI lower back without contrast at M Health Fairview Southdale Hospital. CPT 72148.
What M Health Fairview Southdale Hospital publishes for this service, straight from its standard-charges file, last updated February 6, 2026.
Outpatient / ER
$30.31cash price (self-pay)
$254list price
$28.47–$1,706range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Partners | PMAP | $138 |
| Itasca Medical Care | Managed Medicaid | $138 |
| Primewest | Managed Medicaid | $138 |
| UCare | PMAP | $140 |
| Medica | Managed Medicaid/AccessAbility | $150 |
| Hennepin Health | PMAP | $156 |
| Blue Cross of Minnesota | PMAP | $160 |
| Itasca Medical Care | Medicare Advantage/MSHO | $187 |
| Primewest | MSHO | $187 |
| Sanford Health Plan | Medicare Advantage | $187 |
| Security Health Plan | Medicare Advantage | $187 |
| South Country Health Alliance | Medicare Advantage | $187 |
| United Healthcare | Medicare Advantage | $187 |
| WellCare | Medicare Advantage | $187 |
| America's PPO | EZCare | $193 |
| America's PPO | Health EZ | $193 |
| Blue Cross of Minnesota | Medicare Advantage | $194 |
| Health Partners | Medicare Advantage | $198 |
| America's PPO | Commercial | $201 |
| Medica | Medicare Advantage Non-SNP | $201 |
| UCare | Medicare Advantage/MSHO | $202 |
| Medica | MSHO/Medicare Advantage SNP | $205 |
| Health Partners | Medicare Cost | $205 |
| First Health | Commercial | $208 |
| MultiPlan | Commercial | $216 |
| Health Partners | Federal | $301 |
| Health Partners | Commercial | $306 |
| Health Partners | Cigna Commercial | $322 |
| Health Partners | Cigna Great West | $383 |
| UCare | Individual and Family with M Health Fairview | $428 |
Inpatient
$760cash price (self-pay)
$1,895list price
$987–$1,706range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| America's PPO | EZCare | $987 |
| Sanford Health Plan | Commercial | $1,116 |
| America's PPO | Health EZ | $1,118 |
| America's PPO | Commercial | $1,211 |
| Security Health Plan | Commercial | $1,421 |
| First Health | Commercial | $1,554 |
| MultiPlan | Commercial | $1,611 |
| Private Healthcare Systems | Commercial | $1,611 |
| Wisconsin Physician Services | Commercial | $1,705 |
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