MRI lower back without contrast at Dell Children's Medical Center (Ascension Seton). CPT 72148.
What Dell Children's Medical Center (Ascension Seton) publishes for this service, straight from its standard-charges file, last updated January 1, 2026.
Outpatient / ER
$2,225cash 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 Star Kids | 5003_blue Cross Star Kids (Chi,Dcn) Outpatient 202412 | $199 |
| Superior Ambetter | 3880_superior Ambetter (Chi,Dcn) Outpatient 202409 | $199 |
| BCBS Star | 3693_chirp Blue Cross Star (Chi,Dcn) Inpatient 20240901 | $211 |
| BCBS Star | 4219_chirp Blue Cross Star (Chi,Dcn) 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 |
| UHC Star | 4253_chirp UHC Star (Chi,Dcn) Outpatient 20241201 | $211 |
| BCBS Chip/Chip Perinate | 3594_blue Cross Chip/Star Kids (Chi,Dcn) Inp | $213 |
| Dell Chip/Chip Perinate | 3605_dell Chip/Star Kids (Chi,Dcn) Inpatient | $213 |
| Dell Star | 3704_chirp Dell Star (Chi,Dcn) Inpatient 20240901 | $213 |
| UHC Star | 3737_chirp UHC Star (Chi,Dcn) Inpatient 20240901 | $213 |
| Champva | 1135_champva Rest_tx 20180301 | $218 |
| BCBS Bav Exchange | 4127_blue Cross Blue Shield Bav Exchange 20250101 | $247 |
| Tricare | 1229_tricare Cah Outpatient 20170101 | $264 |
| 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 |
| Superior Star | 4241_chirp Superior Star (Chi,Dcn) Outpatient 20241201 | $1,381 |
| Superior Star Foster | 4188_superior Star Foster Outpatient 20241201 | $1,381 |
| Superior Star Foster | 4189_superior Star Foster (Chi,Dcn) Outpatient | $1,381 |
| Superior Star Kids | 4888_superior Star Kids Outpatient 20241201 | $1,381 |
| Superior Star Kids | 4889_superior Star Kids (Chi,Dcn) Outpatient 2024 | $1,381 |
| Superior Star Plus | 4375_chirp Superior Star Plus (Chi,Dcn) Inpatient | $1,381 |
| Superior Star Plus | 4389_chirp Superior Star Plus (Chi,Dcn) Outpatien | $1,381 |
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All common services at Dell Children's Medical Center (Ascension Seton)