MRI lower back without contrast at St. Luke's Health - Brazosport Hospital. CPT 72148.
What St. Luke's Health - Brazosport Hospital publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$4,113cash price (self-pay)
$11,750list price
$199–$5,875range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| UNITED | Medicaid|All Other Plans | $199 |
| BCBS | Medicaid|All Plans | $207 |
| CHC | Medicaid|All Other Plans | $207 |
| SUPERIOR | Medicaid|All Plans | $207 |
| CHC | Medicaid|CHIP | $223 |
| BCBS | Medicare|All Plans | $242 |
| CIGNA-HEALTHSPRING | Medicare|All Plans | $242 |
| HUMANA | Medicare|All Plans | $242 |
| KELSEY | Medicare|All Plans | $242 |
| UNITED | Medicare|All Plans | $242 |
| SELECTCARE | Medicare|All Plans | $249 |
| WellcareTP | Medicare|All Plans | $249 |
| Community Health Choice | Commercial|Exchange | $254 |
| Devoted | Medicare|All Plans | $259 |
| SCANHealth | Medicare|All Plans | $259 |
| UNITED | Medicaid|STAR | $267 |
| CHC | Medicaid|STAR | $278 |
| Ambetter | Commercial|All Plans | $351 |
| Wellpoint | Commercial|Exchange | $363 |
| Aetna | Commercial|Exchange | $373 |
| United | Commercial|Exchange | $375 |
| Bright Health | Commercial|All Plans | $385 |
| BCBS-TX | Commercial|Blue Advantage HMO | $403 |
| Humana | Commercial|All Plans | $583 |
| Entrust | Commercial|All Plans | $606 |
| UNITED | Medicaid|STARPLUS | $609 |
| BCBS-TX | Commercial|Blue Options | $678 |
| TCHP | Medicaid|All Other Plans | $705 |
| BCBS-TX | Commercial|PPO-POS | $718 |
| BCBS-TX | Commercial|Traditional | $753 |
Inpatient
$4,113cash price (self-pay)
$11,750list price
$5,875–$5,875range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health First | Commercial|All Plans | $5,875 |
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All common services at St. Luke's Health - Brazosport Hospital