MRI lower back without contrast at Roxborough Memorial Hospital. CPT 72148.
What Roxborough Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$243cash price (self-pay)
$3,951list price
$187–$3,832range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Partners Plan | Health Partners Plan Medicaid | $187 |
| Traditional Medicaid | Traditional Medicaid | $187 |
| Humana Military Tricare | Humana Military Tricare | $195 |
| Keystone | Keystone First Medicaid | $198 |
| UHC | UHC Medicaid | $212 |
| Health Partners Plan | Health Partners Plan Medicare | $244 |
| Independence Blue Cross | IBC Medicare | $244 |
| PA Health & Wellness | PA Health & Wellness Medicare & Duals | $244 |
| Traditional Medicare | Traditional Medicare | $244 |
| Tricare | Tricare | $244 |
| UHC | UHC Medicare | $244 |
| UHC | UHC Va Ccn | $244 |
| Providers Partner Health Plan | Provider Partners Health Plan | $251 |
| Keystone | Keystone First Medicare | $254 |
| Ally-Align Medicare | Ally-Align Medicare | $256 |
| Spartan | Spartan Plan | $256 |
| Auto Insurance | Auto Insurance | $268 |
| Worker Compensation | Worker Compensation | $276 |
| PA Health & Wellness | PA Health & Wellness Commercial Insurance Excha | $293 |
| Employer Direct Healthcare | Employer Direct Healthcare | $342 |
| Health Partners Plan | Health Partners Plan Exchange | $366 |
| Naphcare | Naphcare | $378 |
| UHC | UHC Exchange | $384 |
| UHC | UHC Commercial All Payer | $510 |
| Highmark | Highmark Commercial (02-01-2024 to 12-31-2026) | $532 |
| Cigna | Cigna Commercial (05-01-2023 to 12-31-2026) | $577 |
| Independence Blue Cross | IBC Commercial HMO PPO | $1,156 |
| Independence Blue Cross | IBC Indemnity | $1,156 |
| Independence Blue Cross | IBC PPACA | $1,271 |
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