MRI lower back without contrast at Golden Plains Community Hospital. CPT 72148.
What Golden Plains Community Hospital publishes for this service, straight from its standard-charges file, last updated March 16, 2026.
Outpatient / ER
$4,323cash price (self-pay)
$6,175list price
$454–$4,014range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross - Blue Advantage | HMO | $454 |
| Blue Cross Essentials HMO | HMO | $475 |
| Blue Cross PPO / Traditional | PPO/Traditional | $517 |
| Cigna | All Commercial | $1,136 |
| United Healthcare Medicare Advantage | Medicare Advantage | $1,420 |
| WellMed | Medicare Advantage | $1,420 |
| Aetna Medicare Advantage | Medicare Advantage | $1,420 |
| Humana Medicare Advantage | Medicare Advantage | $1,420 |
| United Healthcare Commercial | All Commercial | $1,825 |
| Aetna | All Commercial | $4,014 |
Inpatient
$4,323cash price (self-pay)
$6,175list price
$3,705–$4,199range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Blue Cross - Blue Advantage | HMO | $3,705 |
| Blue Cross Essentials HMO | HMO | $3,890 |
| Aetna | All Commercial | $4,014 |
| Blue Cross PPO / Traditional | PPO/Traditional | $4,199 |
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