MRI lower back without contrast at St. Luke's Health - Springwoods Village Hospital. CPT 72148.
What St. Luke's Health - Springwoods Village Hospital publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$3,529cash price (self-pay)
$10,082list price
$174–$10,082range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Renaissance | Commercial|All Plans | $174 |
| Montgomery Hospital District | Commercial|All Plans | $197 |
| BCBS | Medicaid|All Plans | $207 |
| CHC | Medicaid|All Other Plans | $229 |
| KelseyCare | Commercial|Exchange | $327 |
| BCBS-TX | Commercial|MyBlue Health Exchange | $340 |
| Cigna | Commercial|All Other Plans | $363 |
| Community Health Choice | Commercial|Exchange | $363 |
| Superior Health Plan | Commercial|All Plans | $363 |
| Bright Health | Commercial|All Plans | $385 |
| BCBS-TX | Commercial|Exchange | $396 |
| BCBS-TX | Commercial|Blue Premier | $722 |
| NXHealth | Commercial|All Plans | $787 |
| BCBS-TX | Commercial|HMO | $902 |
| BCBS-TX | Commercial|PPO | $1,014 |
| Cigna | Commercial|Surefit | $1,015 |
| Aetna | Commercial|Transplant | $1,023 |
| Humana | Commercial|HMO | $1,050 |
| Humana | Commercial|PPO | $1,050 |
| Healthsmart | Commercial|AP3-PPO | $1,100 |
| Cigna | Commercial|HMO | $1,119 |
| Aetna | Commercial|PPO | $1,145 |
| KelseyCare | Commercial|All Other Plans | $1,399 |
| United | Commercial|Exchange | $1,535 |
| United | Commercial|HMO | $2,518 |
| United | Commercial|PPO | $2,518 |
| Cigna | Commercial|PPO | $2,812 |
| United | Commercial|Optum | $4,739 |
| CHC | Medicaid|CHIP | $5,545 |
| Aetna-Kelsey Care | Commercial|HMO | $5,948 |
Inpatient
$3,529cash price (self-pay)
$10,082list price
$4,335–$10,082range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| TCHPCHIP | Medicaid|HMO | $4,335 |
| CHC | Medicaid|CHIP | $5,545 |
| CHC | Medicaid|HMO | $5,545 |
| TEXASTRUECHOICE | Medicaid|CHIP | $5,545 |
| Coventry | Commercial|PPO | $6,553 |
| First Health | Commercial|All Plans | $6,553 |
| Cigna | Commercial|Transplant | $7,057 |
| Healthsmart | Commercial|PPO | $7,057 |
| Interlink | Commercial|Transplant | $7,057 |
| MultiPlan | Commercial|All Plans | $7,562 |
| USA Health Network | Commercial|All Plans | $8,570 |
| MHealth Network | Commercial|PPO | $10,082 |
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All common services at St. Luke's Health - Springwoods Village Hospital