MRI lower back without contrast at Lewisgale Hospital-montgomery. CPT 72148.
What Lewisgale Hospital-montgomery publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$6,808cash price (self-pay)
$6,808list price
$291–$6,127range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| United | AllPayerAppendix | $518 |
| Anthem | HIX | $547 |
| Anthem | HMO | $608 |
| Anthem | PPO | $608 |
| Cigna | NPR | $1,185 |
| Lifeworks | MCR | $1,294 |
| Universal Healthcare Group | MCR | $1,498 |
| Virginia Health Network | ULTRA | $2,383 |
| United | OptionsPPO | $2,635 |
| United | GlobalBenefitPlan | $3,064 |
| Aetna | SharedSavings | $3,114 |
| Greenvbrier Sporting Club | COMM | $4,085 |
| Multiplan | PHCS | $4,561 |
| Aetna | Broad | $4,830 |
| Virginia Health Network | COMM | $4,834 |
| Virginia Health Network | WC | $4,834 |
| CorVel | WorkersComp | $4,902 |
| Richfield Nursing Center | COMM | $5,106 |
| Richfield Retirement Community | COMM | $5,106 |
| Community Care Network | COMM | $5,446 |
| Graham-White Manufacturing | COMM | $5,446 |
| OccuNet Workers Comp | WorkersComp | $5,446 |
| One Health Plan | POS | $5,446 |
| One Health Plan | PPO | $5,446 |
| Phcs | Comm | $5,787 |
| Patients Choice | COMM | $5,991 |
| 4Most | COMM | $6,127 |
| American Postal Workers Union | COMM | $6,127 |
| Star Transportation | COMM | $6,127 |
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