MRI lower back without contrast at Providence Holy Family Hospital. CPT 72148.
What Providence Holy Family Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$758cash price (self-pay)
$2,523list price
$266–$975range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Kaiser | Medicare Managed Care Plan | $266 |
| Blue Cross | Premera Medicare Managed Care Plan | $277 |
| Unitedhealthcare | Medicare Managed Care Plan | $285 |
| Blue Shield | Asuris Medicare Managed Care Plan | $287 |
| Amerigroup | Medicare Managed Care Plan | $292 |
| Community Health Plan | Cascade Care Exchange | $425 |
| Blue Cross | Premera - Lifewise Health Plan Of Washington Affordable C | $479 |
| Coordinated Care | Ambetter Exchange | $492 |
| Unitedhealthcare | Aco Tiered Other Commercial Plan | $497 |
| Blue Cross | Premera Heritage Exchange | $544 |
| Blue Cross | Premera All Commercial Plans | $696 |
| Providence Health Plan | Signature/Choice/Extend Ppo Networks Other Co | $698 |
| Aetna | All Commercial Plans | $707 |
| Kaiser | All Commercial Plans | $818 |
| Cigna | All Commercial Plans | $839 |
| Blue Shield | Asuris All Commercial Plans | $917 |
| Unitedhealthcare | Navigate Exchange | $946 |
| Unitedhealthcare | All Commercial Plans | $975 |
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