MRI lower back without contrast at Forks Community Hospital. CPT 72148.
What Forks Community Hospital publishes for this service, straight from its standard-charges file, last updated July 9, 2026.
Outpatient / ER
$3,079cash price (self-pay)
$4,152list price
$318–$4,455range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina Medicare | Molina Medicare | $318 |
| Molina Medicaid | Molina Medicaid | $1,436 |
| Regence Medicaid | Regence Medicaid | $1,436 |
| Amerigroup Medicaid-All Plans | Amerigroup Medicaid-All Plans | $1,522 |
| Coordinated Care (Mco) Mcd-All Plans | Coordinated Care (Mco) Mcd-All | $1,551 |
| UHC Medicaid | UHC Medicaid | $1,848 |
| Community Health Network Mcr-All Other Plans | Community Health Networ | $1,868 |
| Humana Mcr Adv - All Plans | Humana Mcr Adv - All Plans | $1,868 |
| Tricare-All Plans | Tricare-All Plans | $1,868 |
| Triwest-All Plans | Triwest-All Plans | $1,868 |
| UHC Mcr Adv | UHC Mcr Adv | $1,868 |
| Wellcare Med Adv - All Plans | Wellcare Med Adv - All Plans | $2,167 |
| Ambetter Ccwa Exch - All Plans | Ambetter Ccwa Exch - All Plans | $2,167 |
| Regence-All Other Plans | Regence-All Other Plans | $2,391 |
| Community Health Exchange | Community Health Exchange | $2,699 |
| UHC All Payer/Doctors Plan/Nexus-All Other Plans | UHC All Payer/Docto | $3,529 |
| Molina Commercial-All Other Plans | Molina Commercial-All Other Plans | $3,820 |
| Aetna-All Plans | Aetna-All Plans | $3,944 |
| Premera Blue Cross-All Plans | Premera Blue Cross-All Plans | $3,944 |
| First Choice-All Plans | First Choice-All Plans | $4,152 |
| Cigna-All Plans | Cigna-All Plans | $4,152 |
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