MRI lower back without contrast at Southwestern Vermont Medical Center. CPT 72148.
What Southwestern Vermont Medical Center publishes for this service, straight from its standard-charges file, last updated January 1, 2025.
Outpatient / ER
$125cash price (self-pay)
$4,161list price
$47.04–$4,036range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| CDPHP | Medicaid/CHP | $47.04 |
| Health New England | Commercial | $77.11 |
| Allegiance | SWVT Employee Only | $91.14 |
| UHC | Commercial | $91.14 |
| CDPHP | Commercial/Exchange | $93.09 |
| Blue Cross | All Vermont Plans | $93.21 |
| CIGNA | Medicare Advantage | $247 |
| CDPHP | Medicare | $247 |
| Blue Cross | Medicare | $247 |
| Fidelis | Medicare | $247 |
| HNE | Medicare | $247 |
| Humana | Medicare | $247 |
| MVP | Medicare | $247 |
| UHC | Medicare | $247 |
| Wellcare | Medicare | $247 |
| Fidelis | Medicaid | $247 |
| Fidelis | CHP | $247 |
| Fidelis | Essential (Aliessa) | $247 |
| Aetna | Medicare | $247 |
| Fidelis | Exchange (QHP) | $259 |
| Fidelis | Essential | $259 |
| BMC | Healthnet Plan | $263 |
| HNE | Medicaid | $263 |
| MVP | Medicaid | $300 |
| Cigna | Commercial | $307 |
| MVP | NY Exchange Individual Plans | $370 |
| MVP | Essential plan 1,2,5,6 | $370 |
| UHC | Medicaid | $370 |
| Aetna | PPO | $577 |
| MVP | VT Commercial/VT Exchange | $625 |
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