MRI lower back without contrast at Medical City Lewisville Hospital. CPT 72148.
What Medical City Lewisville Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$4.69cash price (self-pay)
$4,946list price
$0.33–$9,887range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina | CHIP | $219 |
| Molina | MCDSTAR | $219 |
| Molina | STAR+PLUS | $219 |
| Molina | STARKIDS | $219 |
| United | NarrowNetworkIndivExchange | $314 |
| United | SmallGroup | $314 |
| Superior Health Plan | CHIP | $346 |
| Superior Health Plan | MCDSTAR | $346 |
| Superior Health Plan | STARHealth | $346 |
| Superior Health Plan | STARKids | $346 |
| Superior Health Plan | STARPLUS | $346 |
| United | AllPayerAppendix | $518 |
| Cigna | IFP | $668 |
| Cigna | QHP | $692 |
| United | OptionsPPO | $955 |
| Unicare | CHIP | $1,187 |
| Healthcare Highways | CityofPlano | $1,672 |
| BCBS | Traditional | $2,048 |
| City of McKinney | COMM | $2,226 |
| Fidelis SecureCare | MGMCR | $2,226 |
| United | GlobalBenefitPlan | $2,226 |
| National ChoiceCare | WCOMP | $2,473 |
| Aetna | ASA | $2,498 |
| Aetna | WCOMP | $2,720 |
| PC Texas Partners | WCOMP | $2,720 |
| Physicians Coop of TX | MGMCR | $2,720 |
| Rockport Health Group | WORKERSCOMP | $2,720 |
| Aetna Coventry First Health | COMM | $2,834 |
| Averde Health, Inc | PPO | $2,869 |
| Coastal Comp Health Networks | WCOMP | $3,462 |
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