MRI lower back without contrast at Aspirus Divine Savior Hospital. CPT 72148.
What Aspirus Divine Savior Hospital publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$629cash price (self-pay)
$4,536list price
$52.25–$3,893range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Mediblue Dual Hmo Snp | $52.25 |
| Humana | Humana Medicare Ppo/Pos/Hmo Network Plans | $64.03 |
| Quartz Health Solutions, Inc. | Quartz Medicare Advantage Plans | $64.03 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Medicare Advantage Pl | $65.32 |
| Dean Health Plan | Dean Health Plan Medicare Advantage | $65.32 |
| United Healthcare Of Wisconsin, Inc. | Va Community Care Network | $65.34 |
| United Healthcare Of Wisconsin, Inc. | United Healthcare Medicare Adva | $66.65 |
| United Healthcare Of Wisconsin, Inc. | United Healthcare Wisconsin Med | $74.41 |
| Dean Health Plan | Dean Health Plan Wisconsin Medicaid Plans | $75.90 |
| First Health Group Corp | First Health National Rental Ppo Network | $124 |
| Security Health Plan Of Wisconsin, Inc. | Security Health Plan Wiscons | $153 |
| Managed Health Services Insurance Corp. | Managed Health Wisconsin Med | $166 |
| Quartz Health Solutions, Inc. | Quartz Fully Insured And Self Insured | $198 |
| Aetna | Medicare Advantage Esa | $232 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Mediblue Access Ppo | $236 |
| Aspirus Health Plan, Inc. | Aspirus Health Plan Hmo/Pos | $371 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Wisconsin Medicaid Pl | $418 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Federal Employee Prog | $480 |
| Wps Health Plan | Wps Statewide Ppo/Pos/Epo Plans | $487 |
| United Healthcare Of Wisconsin, Inc. | United Healthcare Hmo/Ppo/Pos/E | $583 |
| Multiplan, Inc | Aetna Health Plan Ppo Networks | $697 |
| Dean Health Plan | Dean Health Plan Commercial Hmo | $792 |
| Cigna | Cigna Ppo And Open Access Plus Benefit Plans | $852 |
| The Alliance (F/K/A Employer Health Care Alliance Cooperative) | The A | $892 |
| Dean Health Plan | Dean Health Plan Commercial Aso Hmo | $1,456 |
| Dean Health Plan | Dean Health Plan Commercial Pos | $1,456 |
| Dean Health Plan | Dean Health Plan Commercial Ppo | $1,456 |
| Anthem Blue Cross Blue Shield Wisconsin | Anthem Blue Access Ppo | $1,738 |
| Security Health Plan Of Wisconsin, Inc. | Security Administrative Serv | $2,683 |
| Security Health Plan Of Wisconsin, Inc. | Security Health Plan Hmo Pla | $2,683 |
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