MRI lower back without contrast at Health Alliance Mary Avenue Hospital. CPT 72148.
What Health Alliance Mary Avenue Hospital publishes for this service, straight from its standard-charges file, last updated June 24, 2026.
Outpatient / ER
$3,072cash price (self-pay)
$3,072list price
$207–$3,072range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Medicare | Aetna Medicare | $296 |
| Beacon Medicare | Beacon Medicare | $296 |
| Blue Cross Medicare | Blue Cross Medicare | $296 |
| Cdphp Medicare | Cdphp Medicare | $296 |
| Hamaspik (Mcr) | Hamaspik (Mcr) | $296 |
| Medicare Managed 100% Hahv | Medicare Managed 100 Hahv | $296 |
| Mvp Gold (Mcr) | Mvp Gold (Mcr) | $296 |
| Todays Options Medicare | Todays Options Medicare | $296 |
| Medicare | Medicare | $298 |
| Emblem Ghi/Hip Medicare | Emblem Ghi/Hip Medicare | $302 |
| Affinity By Molina Mcr | Affinity By Molina Mcr | $311 |
| Todays Options | Todays Options | $326 |
| Beacon Exchange | Beacon Exchange | $356 |
| UHC Commercial | UHC Commercial | $373 |
| UHC Empire | UHC Empire | $373 |
| UHC Exchange | UHC Exchange | $373 |
| Aetna Hp Network | Aetna Hp Network | $383 |
| Beacon Commercial | Beacon Commercial | $385 |
| VALUE OPTIONS (Non-HMO) | VALUE OPTIONS (Non-HMO) | $445 |
| Mvp Exchange | Mvp Exchange | $1,629 |
| Blue Cross Connection/Exchange | Blue Cross Connection/Exchange | $1,801 |
| Emblem Ghi/Hip PPO/Cbp | Emblem Ghi/Hip PPO/Cbp | $1,905 |
| Mvp HMO/PPO | Mvp HMO/PPO | $1,917 |
| Blue Cross Access | Blue Cross Access | $1,919 |
| Aetna | Aetna | $1,997 |
| Emblem Select Care (Exchange) | Emblem Select Care (Exchange) | $2,089 |
| Cdphp | Cdphp | $2,150 |
| First Health | First Health | $2,150 |
| Magnacare Standard | Magnacare Standard | $2,150 |
| Oxford Exchange | Oxford Exchange | $2,150 |
Inpatient
$3,072cash price (self-pay)
$3,072list price
$2,150–$3,072range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Magnacare Standard | Magnacare Standard | $2,150 |
| Multiplan | Multiplan | $2,519 |
| Blue Shield - Health Now | Blue Shield - Health Now | $2,918 |
| Medigap | Medigap | $3,072 |
| NON CONTRACTED (100% POC) | NON CONTRACTED (100 PerCent POC) | $3,072 |
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