MRI lower back without contrast at Fairfield Hospital District. CPT 72148.
What Fairfield Hospital District publishes for this service, straight from its standard-charges file, last updated April 28, 2026.
Outpatient / ER
$4,134cash price (self-pay)
$5,905list price
$166–$2,953range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United Community Medicaid | Medicaid | $166 |
| Medicare Advantage Plans | Medicare | $239 |
| Medicare | Medicare | $239 |
| BCBS Blue Advantage HMO | HMO | $263 |
| 90 Degrees Benefits | PPO | $358 |
| United Healthcare Commercial | PPO | $423 |
| Aetna Commercial | PPO | $695 |
| BCBS Blue Essentials | HMO | $965 |
| BCBS Blue Traditional/PPO/POS | PPO | $1,060 |
| Curative | PPO | $2,953 |
Inpatient
$4,134cash price (self-pay)
$5,905list price
$695–$2,953range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna Commercial | PPO | $695 |
| Curative | PPO | $2,953 |
| BCBS Blue Traditional/PPO/POS | PPO | $2,953 |
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