MRI lower back without contrast at Mary Imogene Bassett Hospital. CPT 72148.
What Mary Imogene Bassett Hospital publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$177cash price (self-pay)
$2,685list price
$96.52–$4,665range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare | NY Power Authority | $96.52 |
| Mvp | Groups | $114 |
| Mvp | PPO/EPO | $114 |
| Mvp | Select Care | $114 |
| Mvp | Managed Medicaid | $186 |
| BCBS | Excellus Blue | $242 |
| BCBS | Excellus Medicare Advantage | $242 |
| Cigna | Assurant | $300 |
| Mvp | Preferred | $300 |
| Aetna | Medicare Advantage | $306 |
| BCBS | Anthem Medicare Advantage | $306 |
| BCBS | Excellus Blue Medicare Advantage | $306 |
| BCBS | Highmark Medicare Advantage | $306 |
| Cdphp | Medicare Advantage | $306 |
| Emblem | Medicare Advantage | $306 |
| Fidelis | Medicare Advantage | $306 |
| Humana | Medicare Advantage | $306 |
| Mvp | Medicare Advantage | $306 |
| United Healthcare | Madicare Advantage | $306 |
| Cdphp | Managed Medicaid | $505 |
| Emblem | Managed Medicaid | $505 |
| United Healthcare | Managed Medicaid | $505 |
| Fidelis | Managed Medicaid | $682 |
| Mvp | Managed Medicaid Essential | $1,086 |
| Cdphp | Essentials | $1,136 |
| BCBS | Excellus HMO Blue Option Managed Medicaid | $1,555 |
| BCBS | Highmark | $3,762 |
| Cigna | Mvp | $4,264 |
| BCBS | Anthem Exchange | $4,665 |
| BCBS | Empire Exchange | $4,665 |
Inpatient
$177cash price (self-pay)
$353list price
$57.77–$318range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| BCBS | Excellus Child Health Plus Managed Medicaid | $59.09 |
| BCBS | Excellus Essential Managed Medicaid | $59.09 |
| BCBS | Excellus Healthy NY EPO Managed Medicaid | $59.09 |
| BCBS | Excellus Healthy NY Managed Medicaid | $59.09 |
| BCBS | Excellus HMO Blue Option Managed Medicaid | $59.09 |
| BCBS | Excellus Safety Net | $59.09 |
| Cdphp | Child Health Plus | $62.80 |
| Cdphp | Managed Medicaid | $62.80 |
| BCBS | Anthem Medicare Advantage | $66.11 |
| BCBS | Excellus Blue Medicare Advantage | $66.11 |
| BCBS | Excellus Blue Medicare Advantage PPO | $66.11 |
| BCBS | Excellus Medicare Advantage HMO/POS | $66.11 |
| BCBS | Excellus Medicare Advantage PPO | $66.11 |
| BCBS | Excellus Sr Federal | $66.11 |
| BCBS | Highmark Medicare Advantage | $66.11 |
| Cdphp | Medicare Advantage HMO | $66.11 |
| Cdphp | Medicare Advantage PPO | $66.11 |
| Aetna | Medicare Advantage HMO | $68.09 |
| Aetna | Medicare Advantage PPO/EPO | $68.09 |
| Cdphp | Essentials | $75.37 |
| BCBS | Empire Exchange | $93.92 |
| Aetna | Allied Benefit | $98.82 |
| Aetna | Signature | $98.82 |
| BCBS | Excellus | $103 |
| BCBS | Excellus Alliance | $103 |
| BCBS | Excellus Blue Card | $103 |
| BCBS | Excellus Exchange | $103 |
| BCBS | Excellus Federal | $103 |
| BCBS | Excellus HMO Blue Access | $103 |
| BCBS | Excellus PPO/EPO | $103 |
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