MRI lower back without contrast at Mount St. Mary's Hospital. CPT 72148.
What Mount St. Mary's 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 Medicaid [350101] | UHC Medicaid [35010101] | $129 |
| United Healthcare Essential [100253] | UHC Essential Plan 200-250 [100 | $129 |
| Molina Medicaid [350107] | Affinity Molina Chp Non-Medicaid [35010704] | $155 |
| Univera Healthcare Essential [100170] | Univera Essential Plan 200-250 | $160 |
| Fidelis Medicaid [350105] | Fidelis Mltc [35010504] | $166 |
| Beacon Health Medicaid [350100] | Beacon Health Medicaid [35010001] | $166 |
| Independent Health Essential [100166] | Independent Health Essential 2 | $171 |
| Independent Health [100165] | Choice Plus [10016505] | $202 |
| Independent Health [100165] | Iha Article 43 [10016502] | $202 |
| Iha First Choice [800001] | Iha Ch First Choice Deductible Plan [80000 | $202 |
| Independent Health [100165] | Iha Passport [10016507] | $202 |
| Independent Health [100165] | Nova [10016506] | $202 |
| Aetna [100001] | Aetna PPO [10000101] | $263 |
| Univera Healthcare Essential [100170] | Univera Essential Plan 3 And 4 | $303 |
| Amerigroup Medicaid [350002] | Amerigroup Medicaid [35000201] | $335 |
| Medicaid In State Alt Payer [300002] | School Medicaid Alt [30000201] | $335 |
| Amerigroup [350102] | BCBS Amerigroup Mcd [35010203] | $335 |
| Amerigroup [350102] | Chp BCBS Amg Non Mcd [35010202] | $335 |
| Medicaid HMO Other Nys [350104] | Medicaid HMO Other Nys [35010401] | $335 |
| Medicaid Out Of State [309999] | Medicaid Florida [30999905] | $335 |
| Medicaid Out Of State [309999] | Medicaid Maine [30999907] | $335 |
| Medicaid Out Of State [309999] | Medicaid Michigan [30999908] | $335 |
| Medicaid Out Of State [309999] | Medicaid New Hampshire [30999911] | $335 |
| Univera Healthcare Essential [100170] | Univera Essential Plan 1 And 2 | $364 |
| No Fault [114001] | One Beacon Ins [11400110] | $645 |
| WORKERS COMPENSATION [500101] | NCA Comp [5005010] | $645 |
| WORKERS COMPENSATION [500101] | Normandy Insurance Services [5005008] | $645 |
| Workers Compensation [500101] | Sedgwick Managed Care [50010112] | $645 |
| Workers Compensation [500101] | State Insurance Fund [50010101] | $645 |
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