MRI lower back without contrast at Kenmore Mercy Hospital. CPT 72148.
What Kenmore Mercy Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$300cash price (self-pay)
$847list price
$46.75–$1,457range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare Essential [100253] | UHC Essential 3 And 4 [10025302 | $129 |
| United Healthcare Essential [100253] | UHC Essential Plan 200-250 [100 | $129 |
| Univera Healthcare Essential [100170] | Univera Essential Plan 200-250 | $160 |
| Beacon Medicaid Replacement Alt [350124] | Beacon Medicaid Alt [350124 | $166 |
| Independent Health Medicaid [350106] | Medisource [35010601] | $171 |
| INDEPENDENT HEALTH MEDICARE [450122] | IHA Medicare Group [45012205] | $171 |
| Independent Health Essential [100166] | Iha Essential Plan 1 And 2 [10 | $171 |
| Iha First Choice [800001] | Iha Non -Ch First Choice [80000102] | $202 |
| Meritain [100063] | Meritain [10006301] | $263 |
| Aetna [100001] | Aetna Other Commercial [10000109] | $263 |
| Magnacare [100142] | Magnacare [10014201] | $263 |
| Univera Healthcare Essential [100170] | Univera Essential Plan 3 And 4 | $303 |
| Medicaid Out Of State [309999] | Medicaid North Carolina [30999909] | $335 |
| Medicaid Out Of State [309999] | Medicaid Ohio [30999910] | $335 |
| Medicaid Out Of State [309999] | Medicaid Pennsylvania [30999912] | $335 |
| Tuscarora Nation [550120] | Tuscarora Nation Plan [55012005] | $335 |
| Wellpoint Bc Essential [101152] | Wellpoint Bc Essential Pan 1 And 2 [ | $335 |
| Kalos Medicaid [350111] | Kalos Mltc [35011101] | $335 |
| Medicaid Out Of State [309999] | Medicaid New Hampshire [30999911] | $335 |
| Wellpoint Bc Essential [101152] | Wellpoint Bc Essential Plan 200-250 | $335 |
| Wellpoint Bc Essential [101152] | Wellpoint Bc Essential Plan 3 And 4 | $335 |
| Univera Healthcare Essential [100170] | Univera Essential Plan 1 And 2 | $364 |
| WORKERS COMPENSATION [500101] | AmTrust [5005009] | $645 |
| Workers Compensation [500101] | Broadspire Ins [50010110] | $645 |
| Workers Compensation [500101] | First Niagara Risk [50010109] | $645 |
| WORKERS COMPENSATION [500101] | Futurecomp [5005007] | $645 |
| WORKERS COMPENSATION [500101] | NCA Comp [5005010] | $645 |
| WORKERS COMPENSATION [500101] | Northeast Shared Services [5005012] | $645 |
| Workers Compensation [500101] | State Insurance Fund [50010101] | $645 |
| No Fault [114001] | Erie Insurance Nf [1140113] | $645 |
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