MRI lower back without contrast at St. Charles Prineville. CPT 72148.
What St. Charles Prineville publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$2,703cash price (self-pay)
$3,378list price
$156–$3,311range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| OTJ DEPT OF LABOR FEDERAL EMP [652] | US Dept of Labor | $355 |
| KAISER PERMANENTE [334] | OEBB PEBB Non-Contracted | $525 |
| MODA [310] | Moda OEBB PEBB | $568 |
| BRIDGESPAN [342] | Blue Cross Individual | $711 |
| BLUE CROSS [200] | Blue Cross Individual | $711 |
| OTJ TRAVELERS INSURANCE [672] | Oregon Workers Compensation | $711 |
| OTJ CITY COUNTY INS SERVICES [662] | Oregon Workers Compensation | $711 |
| AUTO NATIONWIDE ALLIED INSURANC [601] | Auto Insurance | $711 |
| AUTO LIBERTY MUTUAL AUTO INS [613] | Auto Insurance | $711 |
| AUTO HARTFORD [612] | Auto Insurance | $711 |
| AUTO GEICO CLAIMS OREGON [606] | Auto Insurance | $711 |
| AUTO PROGRESSIVE [608] | Auto Insurance | $711 |
| AUTO SUBLIMITY INSURANCE [616] | Auto Insurance | $711 |
| AUTO DAIRYLAND INSURANCE [617] | Auto Insurance | $711 |
| AUTO AMERICAN FAMILY INSURANCE [603] | Auto Insurance | $711 |
| AUTO SAFECO CONCENTRA [600] | Auto Insurance | $711 |
| AUTO TRAVELERS INSURANCE [615] | Auto Insurance | $711 |
| BLUE CROSS [200] | Blue Cross PPO | $836 |
| Law Enforcement [701] | Schs Sph Hb Law Enforcement | $946 |
| KAISER PERMANENTE MED ADV [136] | Medicare | $946 |
| HEALTH NET MED ADV [135] | Medicare | $946 |
| INDIAN HEALTH [704] | Medicare | $946 |
| MEDICARE ADVANTAGE GENERIC [199] | Medicare | $946 |
| PYRAMID MEDICARE [128] | Medicare | $946 |
| CHAMP VA [700] | Veteran Affairs | $946 |
| AGERIGHT ADVANTAGE [142] | Medicare | $946 |
| BLUE CROSS MED ADV [125] | Blue Cross Medicare | $1,040 |
| HEALTH SHARE OHSU OHP [552] | Oregon Medicaid CCO | $1,182 |
| HEALTH SHARE KAISER [543] | Oregon Medicaid CCO | $1,182 |
| WILLAMETTE VALLEY COMMUNITY HEALTH [536] | Oregon Medicaid CCO | $1,182 |
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