MRI lower back without contrast at SSM Health St. Clare Hospital - Baraboo. CPT 72148.
What SSM Health St. Clare Hospital - Baraboo publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$2,318cash price (self-pay)
$4,215list price
$174–$1,708range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Molina | Medicare Managed Care Plan | $174 |
| Dean Health Plan | Medicare Managed Care Plan | $232 |
| BCBS | Blue Preferred/Blue Preferred Plus HMO/POS | $1,592 |
| BCBS | Blue Access PPO | $1,708 |
| BCBS | Blue Traditional Traditional | $1,708 |
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All common services at SSM Health St. Clare Hospital - Baraboo