MRI lower back without contrast at MaineHealth - Memorial Hospital. CPT 72148.
What MaineHealth - Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 9, 2025.
Outpatient / ER
$4,362cash price (self-pay)
$4,362list price
$69.85–$4,100range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | MHACO Government | $130 |
| Anthem | Medicare Advantage | $188 |
| Wellcare | Medicare Advantage | $188 |
| Aetna | Medicare Advantage | $219 |
| Humana | Medicare Advantage | $219 |
| United Healthcare | Medicare Advantage | $219 |
| Aetna | HMO/PPO | $260 |
| Aetna | MHACO Commercial | $269 |
| Multiplan | Commercial | $315 |
| Community Health Options | Commercial | $324 |
| United Healthcare | Commercial | $332 |
| Harvard Pilgrim Healthcare | Commercial | $379 |
| Harvard Pilgrim Healthcare | Maine's Choice | $379 |
| Anthem | HMO/POS/PPO Pathway Enhanced | $558 |
| Cigna | Commercial | $3,673 |
Inpatient
$4,362cash price (self-pay)
$4,362list price
$3,482–$4,100range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | HMO/POS/PPO Pathway Enhanced | $3,482 |
| Community Health Options | Commercial | $3,490 |
| Harvard Pilgrim Healthcare | Maine's Choice | $3,655 |
| Cigna | Commercial | $3,673 |
| Aetna | HMO/PPO | $3,776 |
| Harvard Pilgrim Healthcare | Commercial | $4,061 |
| Multiplan | Commercial | $4,100 |
| United Healthcare | Commercial | $4,100 |
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