CPT 72148
MRI of the lower back, without contrast
An MRI of the lumbar spine with no contrast, the most common scan for persistent low back pain or sciatica. Billed as a facility charge plus the radiologist's reading.
Billed to Medicare
$377
What providers submitted, on average, for this code in a hospital setting.
Medicare accepted
$69
What Medicare treated as payable. Not a commercial rate or a cash price.
The gap
5.5x
How many times the accepted amount the billed figure was.
National averages from the Centers for Medicare & Medicaid Services, 2024 data, retrieved 2026-09-14. Medicare fee-for-service, physician and practitioner claims only. The hospital's own charge for the same code is separate and is usually higher. Based on 536,847 services.
Among the 8 imaging codes on this site with CMS figures, this gap ranks 5 of 8 (median 5.5x). The widest is CT scan of the head, without contrast at 6x.
Where this line goes wrong
Guidelines say wait
Clinical guidelines advise against imaging for uncomplicated low back pain in the first six weeks, and many insurers deny early MRI on that basis. A denial is a coverage question, not a bill you automatically owe; ask the provider what authorization they obtained.
Facility fee at hospital rates
A hospital-based MRI carries a facility charge that a freestanding center does not. Check which you were billed by.
Check it, then ask
- 1
Ask for the itemized bill and the imaging report, and check that each billed study has a report.
- 2
Check the two halves match: the facility line and the radiologist's line should carry the same code for the same date.
- 3
If the radiologist was out of network for an emergency visit or at an in-network facility, the No Surprises Act limits what you can be billed.
- 4
If you are self-pay, ask for the hospital's published cash price for the scan; it is usually a fraction of the list price.
The full walkthrough for this kind of bill: Your bill came in above the estimate.
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People also ask
My insurance denied the MRI. Do I have to pay the full charge?
It depends on why. If the provider failed to get a required authorization, many contracts bar them from billing you. If the plan judged it not medically necessary, you can appeal with the referring doctor's notes.
Sources
This page explains a billing code in general terms. It is not a coding, legal or medical opinion about your bill, and the code descriptions are mediloop's own plain-English summaries, not the official CPT descriptors, which are owned by the American Medical Association. Whether a charge was correct depends on the record of your visit and your payer's rules.