MRI lower back without contrast at Saint Alphonsus Medical Center-Ontario. CPT 72148.
What Saint Alphonsus Medical Center-Ontario publishes for this service, straight from its standard-charges file, last updated March 31, 2026.
Outpatient / ER
$1,535cash price (self-pay)
$2,361list price
$150–$2,290range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Healthcare Medicare | United Healthcare Medicare Advantage | $278 |
| Moda Health | Moda Select | $552 |
| Huron Valley Pace Medicaid | Medicaid | $708 |
| Health New England Medicaid Advantage | Medicaid | $708 |
| Id County Payette | Medicaid County | $708 |
| Medicaid - Nh | Medicaid | $708 |
| Massachusetts Behavioral Health Partnership | Medicaid | $708 |
| Ucare Medicaid | Medicaid | $708 |
| New York Cancer Services Program | Medicaid | $708 |
| Medicaid - Nj | Medicaid | $708 |
| Community Care Behavorial Health | Medicaid | $708 |
| Rx Medicaid | Medicaid | $708 |
| Medicaid Spenddown | Medicaid | $708 |
| Commonwealth Care Alliance Medicaid | Medicaid | $708 |
| Illinicare Health Medicaid Advantage | Medicaid | $708 |
| Pacificsource Health Plans Medicaid Advantage | Medicaid | $708 |
| Green Mountain Medicaid Advantage | Medicaid | $708 |
| Blue Cross - Nj (Horizon) Medicaid Advantage | Medicaid | $708 |
| Upmc Medicaid Advantage | Medicaid | $708 |
| Trillium Community Ohp | Medicaid | $708 |
| Delaware First Health | Medicaid | $708 |
| Webtpa | Pacific Steel | $750 |
| Mountain Health Co-Op | Mountain Health Cooperative | $1,417 |
| Pacificsource Health Plans | Pacificsource Smart Alliance | $1,417 |
| Allegiance | Woodgrain Millwork | $1,794 |
| Humana | Humana | $2,078 |
| Phcs | Multiplan | $2,125 |
| Ghc Scw | Multiplan | $2,125 |
| Webtpa | First Choice Health | $2,125 |
| Paramount HMO | Multiplan | $2,125 |
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All common services at Saint Alphonsus Medical Center-Ontario