MRI lower back without contrast at Avita Ontario Hospital. CPT 72148.
What Avita Ontario Hospital publishes for this service, straight from its standard-charges file, last updated March 23, 2026.
Outpatient / ER
$4,006cash price (self-pay)
$4,713list price
$431–$5,629range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Caresource | Medicaid_Outpatient | $431 |
| Traditional_Medicaid | Outpatient | $431 |
| Molina | Medicaid_Outpatient | $431 |
| OhioRise | Medicaid_Outpatient | $431 |
| United_HealthCare | Medicaid_Outpatient | $431 |
| Anthem | Medicaid_Outpatient | $444 |
| AmeriHealth | Medicaid_Outpatient | $453 |
| Buckeye | Medicaid_Outpatient | $466 |
| Humana_Horizons | Medicaid_Outpatient | $466 |
| Aetna | Medicare_Outpatient | $1,605 |
| Anthem | Medicare_Outpatient | $1,605 |
| Buckeye | Medicare_Outpatient | $1,605 |
| Humana | Medicare_Outpatient | $1,605 |
| Traditional_Medicare | Outpatient | $1,605 |
| Mount_Carmel | Medicare_Outpatient | $1,605 |
| Molina | Medicare_Outpatient | $1,605 |
| United_HealthCare | Medicare_Outpatient | $1,605 |
| Medical_Mutual | Medicare_Outpatient | $1,637 |
| Molina | Marketplace_Outpatient | $2,413 |
| Anthem | Traditional_Blue_Access_Blue_Preferred | $2,851 |
| Anthem | Blue_Access_I-II_Enhanced_Choice_Pathway_X | $2,875 |
| Anthem | Blue_Access_Blue_Preferred | $2,969 |
| Anthem | Pathway_Group_HMO_Pathway_X | $3,125 |
| Anthem | Medicare_Inpatient | $3,518 |
| Buckeye | Medicare_Inpatient | $3,518 |
| Humana | Medicare_Inpatient | $3,518 |
| Traditional_Medicare | Inpatient | $3,518 |
| Mount_Carmel | Medicare_Inpatient | $3,518 |
| Molina | Medicare_Inpatient | $3,518 |
| Aetna | Medicare_Inpatient | $3,588 |
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