MRI lower back without contrast at UPMC Lititz. CPT 72148.
What UPMC Lititz publishes for this service, straight from its standard-charges file, last updated March 6, 2026.
Outpatient / ER
$1,656cash price (self-pay)
$2,760list price
$230–$2,346range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Highmark BCBS of PA | Medicare | $230 |
| Aetna | Medicare | $242 |
| Cigna | Medicare | $244 |
| Geisinger | Medicare | $244 |
| United Healthcare Community Plan for Families | PA Medicaid | $245 |
| United Healthcare | Medicare | $248 |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $325 |
| Highmark Wholecare (prev Gateway) | Medicaid | $325 |
| UPMC Health Plan | Managed Medicaid | $333 |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $349 |
| Keystone Autism Services | ACAP | $371 |
| Geisinger | Medicaid/CHIP | $373 |
| OneCall | Worker's Comp | $400 |
| Premier Comp Solutions | Worker's Comp | $425 |
| Prime Net | Managed Medicare | $519 |
| Capital Blue Cross | Medicare Advantage | $552 |
| Keystone Health Plan | Medicare Advantage | $552 |
| Highmark BCBS of PA | Commercial - Children's Health Insurance | $686 |
| Highmark BCBS of PA | Medicaid | $715 |
| Highmark BCBS of PA | Commercial | $730 |
| Prime Net | Legacy Commercial | $1,076 |
| Aetna | ACO | $1,085 |
| Prime Net | ACO | $1,085 |
| Cigna | Commercial | $1,225 |
| Prime Net | NonGateKeeper | $1,283 |
| UPMC Work Partners | Workers Comp | $1,285 |
| Aetna | Commercial | $1,292 |
| Prime Net | GateKeeper | $1,292 |
| Capital Blue Cross | CHIP | $1,295 |
| Capital Blue Cross | Commercial | $1,295 |
Inpatient
$1,656cash price (self-pay)
$2,760list price
$1,024–$2,346range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Prime Net | Legacy Commercial | $1,024 |
| Aetna | ACO | $1,032 |
| Prime Net | ACO | $1,032 |
| Prime Net | NonGateKeeper | $1,220 |
| Aetna | Commercial | $1,228 |
| Prime Net | GateKeeper | $1,228 |
| Preferred Healthcare System | Inter County Health Plan/Lancaster Gener | $1,518 |
| Geisinger | Commercial | $1,994 |
| Prime Net | FH-Medical Rental | $1,998 |
| Preferred Healthcare System | PPO | $2,070 |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,346 |
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