MRI lower back without contrast at Jefferson Hospital. CPT 72148.
What Jefferson Hospital publishes for this service, straight from its standard-charges file, last updated April 14, 2026.
Outpatient / ER
$37.43cash price (self-pay)
$1,477list price
$57.76–$1,007range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Univera | Univera Essential Plan | $131 |
| Univera | Univera Healthy New York | $131 |
| Highmark | Highmark Together Blue | $141 |
| Univera | Univera Medicare | $162 |
| Univera | Univera Commercial | $190 |
| Highmark | Highmark My Direct Blue | $191 |
| Highmark | Highmark Community Blue Medicare PPO | $214 |
| Highmark | Highmark Complete Blue Medicare | $214 |
| Highmark | Highmark Freedom Blue | $216 |
| Highmark | Highmark Blue High Performance | $220 |
| Highmark | Highmark Community Blue | $220 |
| Highmark | Highmark Connect Blue | $220 |
| Highmark | Highmark Indemnity | $220 |
| Highmark | Highmark Managed Care | $220 |
| Highmark | Highmark My Blue Access | $220 |
| Highmark | Highmark Performance Blue | $220 |
| Highmark | Highmark Social Mission Indemnity | $220 |
| Highmark | Highmark Social Mission Managed Care | $220 |
| American Health Plans | American Health Plans Medicare | $233 |
| Devoted Medicare | Devoted Health Medicare Advantage | $240 |
| Aetna | Aetna Medicare | $242 |
| Highmark | Highmark Community Blue Medicare HMO | $242 |
| Highmark | Highmark Security Blue | $242 |
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $244 |
| Cigna | Cigna Medicare | $249 |
| United Healthcare | United Healthcare Of OH Medicaid | $258 |
| University of Pittsburgh Medical Center | University of Pittsburgh Med | $264 |
| United Healthcare | United Healthcare Medicaid | $300 |
| Cigna | Cigna Commercial | $306 |
| Aetna | Aetna Better Health CHIP | $307 |
Inpatient
$2,232cash price (self-pay)
$2,756list price
$57.76–$400range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $72.40 |
| Amerihealth | Amerihealth Caritas Medicare (NY) | $72.40 |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $91.01 |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $99.98 |
| Amerihealth | Amerihealth Caritas HC Medicaid | $99.98 |
| Geisinger | Geisinger CHIP | $99.98 |
| Geisinger | Geisinger Medicaid HC | $99.98 |
| United Healthcare | United Healthcare Medicaid | $99.98 |
| Univera | Univera Essential Plan | $102 |
| Univera | Univera Healthy New York | $102 |
| Univera | Univera Medicare | $126 |
| Univera | Univera Commercial | $148 |
| Highmark | Highmark Together Blue | $149 |
| Highmark | Highmark Blue High Performance | $157 |
| Highmark | Highmark Community Blue | $157 |
| Highmark | Highmark Connect Blue | $157 |
| Highmark | Highmark Indemnity | $157 |
| Highmark | Highmark Managed Care | $157 |
| Highmark | Highmark My Blue Access | $157 |
| Highmark | Highmark My Direct Blue | $157 |
| Highmark | Highmark Performance Blue | $157 |
| Highmark | Highmark Social Mission Indemnity | $157 |
| Highmark | Highmark Social Mission Managed Care | $157 |
| Cigna | Cigna Commercial | $194 |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $245 |
| United Healthcare | United Healthcare Of OH Medicaid | $258 |
| United Healthcare | United Healthcare Commercial | $258 |
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