MRI lower back without contrast at Alta Vista Regional Hospital. CPT 72148.
What Alta Vista Regional Hospital publishes for this service, straight from its standard-charges file, last updated April 16, 2026.
Outpatient / ER
$3,910cash price (self-pay)
$7,819list price
$343–$7,819range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Commercial HMO PPO | Western Sky Ambetter | $343 |
| Medicaid HMO | Molina Of TX Mcd | $367 |
| Medicaid Ffs | Az Ffs Medicaid | $367 |
| Medicaid Ffs | Colorado Ffs Medicaid | $367 |
| Medicaid Ffs | Ia Ffs Medicaid | $367 |
| Medicaid Ffs | Wy Ffs Medicaid | $367 |
| Php Centennial | Php Centennial | $367 |
| Medicaid HMO | Turquoise BCBS Mcd | $444 |
| Medicaid HMO | Turquoise Molina Mcd | $444 |
| Medicaid HMO | Turquoise Presb Mcd | $444 |
| Medicaid HMO | Turquoise UHC Mcd | $444 |
| Medicaid HMO | Turquoise Care Mcd | $444 |
| Medicaid Ffs | Medicaid Consultec | $444 |
| Medicaid Ffs | Nm Ffs Medicaid | $444 |
| Commercial HMO PPO | Pres Ind Sel | $444 |
| Commercial HMO PPO | Presby Ind Sel | $444 |
| Medicare HMO | Aetna Medicare Advantage | $1,095 |
| UHC Advantage | UHC Advantage | $1,095 |
| Medicare HMO | BCBS Medicare | $1,127 |
| Medicare | Medicare | $1,251 |
| Medicare HMO | Molina Medicare Advantage | $1,251 |
| Misc Medicare Advantage | Misc Medicare Advantage | $1,251 |
| Medicare HMO | Humana Mcr PPO | $1,251 |
| Champus | Triwest | $1,251 |
| Medicare HMO | Aarp UHC Life1 | $1,251 |
| Medicare HMO | Cigna Medicare Advantage | $1,251 |
| Medicare HMO | Presby Medicare Adv | $1,251 |
| Workers Comp | Workers Comp | $3,206 |
| Self Pay | Self Pay | $3,910 |
| Other Covernment | Nm Behavioral Hlth | $4,887 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.