MRI lower back without contrast at Wayne Memorial Hospital. CPT 72148.
What Wayne Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 16, 2026.
Outpatient / ER
$3,037cash price (self-pay)
$4,339list price
$254–$3,471range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| MEDICARE ADVANTAGE 100Percentage | MEDICARE ADVANTAGE 100Percentage | $254 |
| Humana | Humana | $256 |
| Upmc Medicare | Upmc Medicare | $264 |
| Ambetter | AMBETTER | $269 |
| Pa Health & Wellness | Pa Health Wellness | $269 |
| WELLPATH (State Prison) | WELLPATH (State Prison) | $330 |
| WELLPATH (Federal Prison) | WELLPATH (Federal Prison) | $469 |
| Blue Cross | Blue Cross | $1,736 |
| KeyStone First | KEYSTONE FIRST | $1,736 |
| Upmc | Upmc | $2,343 |
| Geisinger | Geisinger | $2,994 |
| Cigna | Cigna | $3,037 |
| Phcs | Phcs | $3,037 |
| Self-Pay | Self-Pay | $3,037 |
| UHC | UHC | $3,037 |
| Aetna | Aetna | $3,254 |
| MultiPlan | MULTIPLAN | $3,471 |
Inpatient
$3,037cash price (self-pay)
$4,339list price
$1,736–$3,471range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| KeyStone First | KEYSTONE FIRST | $1,736 |
| Phcs | Phcs | $3,037 |
| Self-Pay | Self-Pay | $3,037 |
| MultiPlan | MULTIPLAN | $3,471 |
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