MRI lower back without contrast at Grace Surgical Hospital. CPT 72148.
What Grace Surgical Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$360cash price (self-pay)
$2,990list price
$233–$1,523range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Bcbs | Vapc3 Government | $233 |
| Aetna | Medicare Managed Care Plan | $240 |
| Superior | Wellcare Medicare Managed Care Plan | $252 |
| Unitedhealthcare | Medicare Managed Care Plan | $253 |
| Baylor Scott And White | Individual Bsw Premier Exchange | $458 |
| Baylor Scott And White | Group Bsw Premier/Covenant Preferred All Comm | $554 |
| Bcbs | Par Traditional | $569 |
| Baylor Scott And White | Group Bsw Plus All Commercial Plans | $772 |
| Bcbs | Ppo | $1,102 |
| Bcbs | Ers Hmo | $1,144 |
| Bcbs | Hmo | $1,144 |
| Aetna | Preferred Other Commercial Plan | $1,303 |
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