MRI lower back without contrast at Frisbie Memorial Hospital. CPT 72148.
What Frisbie Memorial Hospital publishes for this service, straight from its standard-charges file, last updated March 1, 2026.
Outpatient / ER
$5,016cash price (self-pay)
$5,016list price
$358–$4,013range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AmeriHealth Caritas | MCD | $413 |
| Well Sense Health Plan | MCD | $612 |
| Anthem | BlueChoice | $673 |
| Anthem | HPN | $706 |
| Anthem | FEP | $779 |
| Anthem | PPO | $779 |
| Anthem | HMO | $785 |
| Anthem | IndividualOffExhange | $785 |
| Anthem | POS | $785 |
| Harvard Pilgrim | INDIVIDUAL | $1,331 |
| Maine Community Health | Individual | $1,431 |
| Maine Community Health | SmallGroup | $1,431 |
| Harvard Pilgrim | ELEVATE | $1,612 |
| Tufts Health Plan | HMO | $1,720 |
| Tufts Health Plan | PPO | $1,720 |
| United | FreedomBenefitPlans | $1,720 |
| Harvard Pilgrim | HMO | $2,032 |
| Harvard Pilgrim | POS | $2,032 |
| Harvard Pilgrim | PPO | $2,032 |
| United | AllPayerAppendix | $2,102 |
| Maine Community Health | LargeGroup | $2,425 |
| Cigna | HMO | $2,711 |
| Tufts Health Plan | POS | $2,869 |
| Aetna | EPO | $2,899 |
| Aetna | HMO | $2,899 |
| Aetna | POS | $2,899 |
| Aetna | PPO | $2,899 |
| United | OptionsPPO | $3,025 |
| Cigna | PPO | $3,521 |
| EverNorth | COMM | $4,013 |
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