MRI lower back without contrast at Ascension Seton Smithville (Ascension Seton). CPT 72148.
What Ascension Seton Smithville (Ascension Seton) publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$1,144cash price (self-pay)
$3,316list price
$156–$1,969range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Champva | 1136_champva Austin 20180301 | $156 |
| BCBS Chip/Chip Perinate | 4168_blue Cross Chip (Chi,Dcn) Outpatient 20 | $199 |
| BCBS Chip/Chip Perinate | 4168_blue Cross Chip/Star Kids (Chi,Dcn) Out | $199 |
| BCBS Chip/Chip Perinate | 4174_blue Cross Chip (Smv) Outpatient 202412 | $199 |
| BCBS Star Kids | 5003_blue Cross Star Kids (Chi,Dcn) Outpatient 202412 | $199 |
| BCBS Star Kids | 5015_blue Cross Star Kids (Smv) Outpatient 20241201 | $199 |
| Dell Chip/Chip Perinate | 4185_dell Chip/Star Kids (Smv) Outpatient 20 | $199 |
| Dell Star | 4236_chirp Dell Star (Smv) Outpatient 20241201 | $199 |
| Superior Ambetter | 3880_superior Ambetter (Chi,Dcn) Outpatient 202409 | $199 |
| BCBS Chip/Chip Perinate | 4174_blue Cross Chip/Star Kids (Smv) Outpati | $211 |
| BCBS Star | 3693_chirp Blue Cross Star (Chi,Dcn) Inpatient 20240901 | $211 |
| BCBS Star | 4219_chirp Blue Cross Star (Chi,Dcn) Outpatient 20241201 | $211 |
| BCBS Star | 4225_chirp Blue Cross Star (Smv) Outpatient 20241201 | $211 |
| Dell Chip/Chip Perinate | 4179_dell Chip/Star Kids (Chi,Dcn) Outpatien | $211 |
| Dell Star | 4230_chirp Dell Star (Chi,Dcn) Outpatient 20241201 | $211 |
| Superior Ambetter | 3879_superior Ambetter (Chi,Dcn) Inpatient 2024090 | $211 |
| BCBS Chip/Chip Perinate | 3594_blue Cross Chip/Star Kids (Chi,Dcn) Inp | $213 |
| BCBS Chip/Chip Perinate | 3600_blue Cross Chip/Star Kids (Smv) Inpatie | $213 |
| BCBS Star | 3699_chirp Blue Cross Star (Smv) Inpatient 20240901 | $213 |
| Dell Chip/Chip Perinate | 3605_dell Chip/Star Kids (Chi,Dcn) Inpatient | $213 |
| Dell Chip/Chip Perinate | 3611_dell Chip/Star Kids (Smv) Inpatient 202 | $213 |
| Dell Star | 3704_chirp Dell Star (Chi,Dcn) Inpatient 20240901 | $213 |
| Dell Star | 3710_chirp Dell Star (Smv) Inpatient 20240901 | $213 |
| Champva | 1135_champva Rest_tx 20180301 | $218 |
| BCBS Bav Exchange | 4127_blue Cross Blue Shield Bav Exchange 20250101 | $247 |
| BCBS Hpn | 4440_blue Cross Blue Shield Hpn 20250501 | $855 |
| BCBS Hpn | 4497_blue Cross Blue Shield Hpn (Dell, Williamson,Hays) 202 | $855 |
| BCBS HMO Essentials | 4095_blue Cross Blue Shield HMO Essentials 20250 | $941 |
| BCBS PPO | 4094_blue Cross Blue Shield PPO 20250101 | $1,042 |
| Superior Star | 3509_chirp Superior Star (Chi,Dcn) Inpatient 20240901 | $1,381 |
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All common services at Ascension Seton Smithville (Ascension Seton)