MRI lower back without contrast at UPMC Northwest. CPT 72148.
What UPMC Northwest publishes for this service, straight from its standard-charges file, last updated March 6, 2026.
Outpatient / ER
$2,205cash price (self-pay)
$3,675list price
$209–$3,124range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UPMC Health Plan | Managed Medicare | $209 |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue | $230 |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $236 |
| Aetna | Medicare | $237 |
| United Healthcare | Unison Advantage Non Special Needs | $242 |
| Aetna of PA | Medicare | $242 |
| Highmark Wholecare (prev Gateway) | Medicare | $249 |
| AmeriHealth Caritas | Medicare | $249 |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advant | $249 |
| United Healthcare | Unison Advantage Special Needs | $254 |
| UPMC Health Plan | Managed Medicaid | $282 |
| United Healthcare Community Plan for Families | Unison Kids | $295 |
| Aetna | Medicaid | $307 |
| Highmark Wholecare (prev Gateway) | Medicaid | $380 |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $400 |
| PA Health & Wellness | PA Medicaid HMO | $437 |
| UPMC Health Plan | Commercial | $541 |
| UPMC Work Partners | Workers Comp | $1,247 |
| Aetna | EBR ASO | $1,470 |
| Cigna | Commercial | $1,470 |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Ca | $1,608 |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,981 |
| Aetna | EBR FI | $2,205 |
| Aetna | Neighborhood Network | $2,205 |
| Aetna | Home Depot Employer Group | $2,267 |
| Aetna | NBR ASO/FI | $2,315 |
| Cigna | New Business ASO | $2,315 |
| InterGroup | PPO | $2,517 |
| Coventry/First Health | Commercial | $2,573 |
| Health Coalition Partners | PPO | $2,646 |
Inpatient
$2,205cash price (self-pay)
$3,675list price
$1,470–$3,704range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | EBR ASO | $1,470 |
| Cigna | Commercial | $1,470 |
| Aetna | EBR FI | $2,132 |
| Aetna | Neighborhood Network | $2,279 |
| Aetna | Home Depot Employer Group | $2,341 |
| Aetna | NBR ASO/FI | $2,389 |
| Cigna | New Business ASO | $2,389 |
| Coventry/First Health | Commercial | $2,573 |
| Private Health Care Systems | PPO | $2,940 |
| InterGroup | PPO | $3,046 |
| Humana | Commercial | $3,124 |
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