MRI lower back without contrast at Jefferson Memorial Hospital. CPT 72148.
What Jefferson Memorial Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$1,391cash price (self-pay)
$6,286list price
$84.26–$6,286range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| TN Medicaid Non-Par | TN Medicaid Non-Par | $84.26 |
| United Healthcare | UHC Community Plan | $84.26 |
| Amerigroup | Amerigroup Community Care | $170 |
| NODE Tricare | NODE Tricare | $206 |
| Humana | NODE Humana MCR ADV | $213 |
| NODE Medicare Non Par | NODE Medicare Non Par | $213 |
| NODE Medicare Traditional | NODE Medicare Traditional | $213 |
| Node UHC Mcr Adv | Node UHC Mcr Adv | $213 |
| Veterans Eval Services | Veterans Eval Services | $216 |
| NODE ChampVA | NODE ChampVA | $216 |
| NODE BlueCare Plus TN MCR ADV | NODE BlueCare Plus TN MCR ADV | $216 |
| NODE Hospice Non Par Agree | NODE Hospice Non Par | $216 |
| NODE United Optum VA CCN | NODE United Optum VA CCN | $216 |
| Node Va | Node Va | $216 |
| NODE Devoted Health MCR ADV | NODE Devoted Health MCR ADV | $217 |
| NODE Farm Bureau MCR ADV | NODE Farm Bureau MCR ADV | $217 |
| NODE Aetna MCR ADV | NODE Aetna MCR ADV | $219 |
| Node BCBS Mcr Adv | Node BCBS Mcr Adv | $219 |
| NODE Healthspring MCR ADV | NODE Healthspring MCR ADV | $219 |
| NODE Amerigroup MCR ADV | NODE Amerigroup MCR ADV | $224 |
| United Healthcare | NODE UHC MCR Dual ADV | $224 |
| NODE Wellcare MCR ADV | NODE Wellcare MCR ADV | $225 |
| Node Nhc Mcr Adv | Node Nhc Mcr Adv | $234 |
| NODE US Dept of Labor | NODE US Dept of Labor | $271 |
| BCBS TN | BCBS TN Net S | $305 |
| Cigna | Cigna ALL | $312 |
| BlueCare | BCBS TN BlueCare | $352 |
| BlueCare | BCBS TN TennCare Select | $352 |
| NovaNet Work Comp TN | NovaNet Work Comp TN | $359 |
| Occunet Work Comp TN | Occunet Work Comp TN | $363 |
Inpatient
$1,391cash price (self-pay)
$6,286list price
$1,276–$6,286range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CHS Group Health Plan BCBST | CHS Group Health Plan BCBST | $1,276 |
| Multiplan Complementary | Multiplan Complementary | $4,966 |
| United Healthcare | UHC APA | $6,286 |
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