MRI lower back without contrast at Maple Grove Hospital. CPT 72148.
What Maple Grove Hospital publishes for this service, straight from its standard-charges file, last updated September 25, 2026.
Outpatient / ER
$741cash price (self-pay)
$1,407list price
$165–$2,340range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Partners [1061] | Mgh Hp Govt Msho | $165 |
| Blue Cross [1021] | Mgh BCBS Pmap | $189 |
| Medicaid [1087] | Mgh Medicaid Mn | $218 |
| Blue Cross [1021] | Mgh BCBS Msho | $245 |
| Humana [2203] | Mgh Humana Med Adv | $245 |
| Medicare [1088] | Mgh Medicare | $245 |
| Ucare [1148] | Mgh Ucare Pmap | $245 |
| Health Partners [1061] | Mgh Hp Med Adv | $245 |
| Medica [1086] | Mgh Medica Med Adv | $247 |
| Ucare [1148] | Mgh Ucare Med Adv | $252 |
| Blue Cross [1021] | Mgh BCBS Med Adv | $252 |
| Ucare [1148] | Mgh Ucare Msho | $252 |
| United Healthcare [2204] | Mgh UHC Med Adv | $254 |
| Allina Health-Aetna [2201] | Mgh Allina Health Aetna Medicare | $266 |
| Blue Cross [1021] | Mgh Xr Hb BCBS Federal | $426 |
| Blue Cross [1021] | Mgh Xr Hb BCBS Aware | $434 |
| Ucare [1148] | Mgh Ucare Ifb | $447 |
| Cigna Health Partners [1242] | Mgh Hp Cigna | $452 |
| Health Partners [1061] | Mgh Hp Federal | $452 |
| Health Partners [1061] | Mgh Hp Comm | $452 |
| America'S PPO [1010] | America'S PPO Healthez Reimbursement Contract | $952 |
| Medica [1086] | Medica Choice Care | $999 |
| America'S PPO [1010] | America'S PPO Reimbursement Contract | $1,013 |
| Phcs [1172] | Phcs Reimbursement Contract | $1,055 |
| Multiplan [1176] | Multiplan Reimbursement Contract | $1,126 |
| Medica [1086] | Mgh Medica Msho | $1,157 |
| Medica [1086] | Medica Acclaim | $2,122 |
| Medica [1086] | Medica Fv Nm - Aco Vantage | $2,180 |
| MEDICA [1086] | MEDICA COMMERCIAL (With WH) | $2,340 |
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