MRI lower back without contrast at Samaritan Pacific Communities Hospital. CPT 72148.
What Samaritan Pacific Communities Hospital publishes for this service, straight from its standard-charges file, last updated January 31, 2026.
Outpatient / ER
$422cash price (self-pay)
$2,160list price
$59.53–$2,165range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Devoted Health | Medicare Advantage - Midlevel - Nonfac | $92.01 |
| Devoted Health | Medicare Advantage - Midlevel - Fac | $92.01 |
| Healthnet | Medicare Advantage - Midlevel - Fac | $92.01 |
| DEVOTED HEALTH | Medicare Advantage-NONFAC | $107 |
| DEVOTED HEALTH | Medicare Advantage-FAC | $107 |
| Healthnet | Medicare Advantage - Nonfac | $108 |
| Healthnet | Medicare Advantage - Fac | $108 |
| Cigna | Facility | $139 |
| Cigna | Nonfacility | $139 |
| Aetna | Fac - Midlevel Lcsw/Lpc/Rdn | $167 |
| Aetna | Nonfac - Midlevel Lcsw/Lpc/Rdn | $167 |
| Aetna | Fac - Optometrists - Pyschologists- Pt-St-Ot | $190 |
| Aetna | Nonfac - Optometrists - Pyschologists- Pt-St-Ot | $190 |
| Aetna | Nonfac - Midlevel Np-Pa-Cnm | $190 |
| Aetna | Fac - Midlevel Np-Pa-Cnm | $190 |
| Aetna | Nonfac - Psychiatric Np | $223 |
| Aetna | Fac - Md-Do | $223 |
| Aetna | Nonfac - Md-Do | $223 |
| Aetna | Fac - Psychiatric Np | $223 |
| First Choice | Nonfacility | $225 |
| First Choice | Facility | $225 |
| Providence | Medicare Adv. | $733 |
| Humana | Medicare Adv. | $740 |
| Samaritan | Medicare Adv. | $740 |
| Regence | Medicare Adv. | $806 |
| Providence | Medicare Adv. - Physician | $806 |
| Pacificsource | Medicare Adv. | $821 |
| Devoted Health | Devoted Health Mcr Advantage | $842 |
| Samaritan | Samaritan Choice | $1,033 |
| Samaritan | Samaritan Group | $1,090 |
Billed more than this?
Scan my billSnap a photo of your bill. We compare every line with these prices and coding rules, free.
All common services at Samaritan Pacific Communities Hospital