MRI lower back without contrast at fairview hospital. CPT 72148.
What fairview hospital publishes for this service, straight from its standard-charges file, last updated June 15, 2026.
Outpatient / ER
$1,084cash price (self-pay)
$1,668list price
$0.87–$1,668range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| AETNA | Acop | $0.87 |
| AETNA | Asa_Whirlpool_Peia | $1.01 |
| OPTUM | Managed Medicaid Transplant | $209 |
| HUMANA | Medicare Advantage HMO | $213 |
| MMO | Medicare Advantage HMO | $224 |
| Aetna | Medicare Advantage | $226 |
| Anthem | Medicare Advantage | $226 |
| Devoted Health | Medicare Advantage | $226 |
| MMO | Medicare Advantage PPO | $231 |
| ANTHEM | Managed Medicaid | $231 |
| Buckeye | Managed Medicaid | $231 |
| MOLINA | Managed Medicaid | $231 |
| Cigna | Medicare Advantage | $233 |
| CARESOURCE | Managed Medicaid | $236 |
| CommuniCare | MEDICARE ADVANTAGE | $237 |
| AMERIHEALTH | Managed Medicaid | $242 |
| Anthem | Hpn | $351 |
| Cc Ehp | All Products | $564 |
| Anthem | PPO/HMO | $651 |
| Mmo | All Products | $655 |
| Aultcare | PPO/HMO | $696 |
| Amish Community Aid Plan | ALL PRODUCTS | $751 |
| Ohcp | All Products | $811 |
| Omas | All Products | $834 |
| Mmo | Traditional | $869 |
| Mmo | Nasco | $869 |
| Ohio Healthy | TRANSPLANT | $901 |
| Healthsmart | All Products | $917 |
| Anthem | Traditional | $932 |
| AETNA | International | $976 |
Inpatient
$1,084cash price (self-pay)
$1,668list price
$472–$1,668range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Oscar | All Products | $602 |
| Amish Community Aid Plan | ALL PRODUCTS | $834 |
| Anthem | Traditional | $961 |
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