MRI lower back without contrast at Westfield Memorial Hospital. CPT 72148.
What Westfield Memorial Hospital publishes for this service, straight from its standard-charges file, last updated April 14, 2026.
Outpatient / ER
$43.34cash price (self-pay)
$2,176list price
$57.76–$549range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Univera | Univera Essential Plan | $102 |
| Univera | Univera Healthy New York | $102 |
| Univera | Univera Medicare | $126 |
| Highmark | Highmark Together Blue | $147 |
| Univera | Univera Commercial | $148 |
| Highmark | Highmark Blue High Performance | $185 |
| Cigna | Cigna Commercial | $194 |
| Highmark | Highmark Community Blue | $220 |
| Highmark | Highmark Connect Blue | $220 |
| Highmark | Highmark Indemnity | $220 |
| Highmark | Highmark Managed Care | $220 |
| Highmark | Highmark My Blue Access | $220 |
| Highmark | Highmark My Direct Blue | $220 |
| Highmark | Highmark Performance Blue | $220 |
| Highmark | Highmark Social Mission Indemnity | $220 |
| Highmark | Highmark Social Mission Managed Care | $220 |
| United Healthcare | United Healthcare Of OH Medicaid | $258 |
| Highmark | Highmark Community Blue Medicare PPO | $263 |
| Highmark | Highmark Complete Blue Medicare | $263 |
| Highmark | Highmark Freedom Blue | $266 |
| American Health Plans | American Health Plans Medicare | $286 |
| United Healthcare | United Healthcare Commercial | $295 |
| Devoted Medicare | Devoted Health Medicare Advantage | $295 |
| Aetna | Aetna Medicare | $297 |
| Highmark | Highmark Community Blue Medicare HMO | $297 |
| Highmark | Highmark Security Blue | $297 |
| Highmark | Highmark Together Blue Medicare | $297 |
| United Healthcare | United Healthcare Medicaid | $300 |
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $300 |
| Amerihealth | Amerihealth Medicare New York | $300 |
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