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MRI lumbar spine with and without contrast

CPT 72149 · negotiated-rate distribution across hospitals in IN

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Hospitals
19
Min
$250.13
Median
$250.13
Max
$3,260.45
Range multiplier
13.0×

By payer (43 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Anthem BCBS6249$64.01$332.81$2,843.9044.4×
UnitedHealthcare783$50.49$250.13$824.4516.3×
Medicaid672$64.01$162.35$226.363.5×
mhs care connect636$64.01$162.35$226.363.5×
Humana722$250.13$250.13$362.061.4×
Aetna721$250.13$250.13$734.882.9×
Medicare Advantage720$250.13$250.13$365.651.5×
Medicare714$250.13$250.13$358.481.4×
patoka valley tier 1614$332.81$332.81$332.811.0×
patoka valley tier 2614$332.81$332.81$332.811.0×
Ambetter78$250.13$250.13$681.112.7×
Cigna18$336.35$551.38$888.922.6×
corizon66$250.13$250.13$250.131.0×
ascension complete mcr66$250.13$250.13$250.131.0×
encore exclusive66$332.81$332.81$332.811.0×
smarthealth ppo66$339.26$339.26$339.261.0×
personalized care66$250.13$250.13$250.131.0×
immergrun66$250.13$250.13$250.131.0×
CareSource66$250.13$250.13$250.131.0×
secure horizons-pacificare66$250.13$250.13$250.131.0×
smarthealth ppo/hdhp 2016100166$339.26$339.26$339.261.0×
WellCare12$358.48$358.48$358.481.0×
avmed exchange12$645.26$645.26$645.261.0×
bc advantage mcr replacement12$358.48$358.48$358.481.0×
Blue Cross Blue Shield12$358.48$358.48$358.481.0×
careplus mcr replacement12$365.65$365.65$365.651.0×
employer direct healthcare12$627.34$627.34$627.341.0×
Molina12$663.19$663.19$663.191.0×
occunet12$663.19$734.89$806.581.2×
Oscar Health12$573.57$573.57$573.571.0×
pace place12$358.48$358.48$358.481.0×
research study encore borland-groover12$358.48$358.48$358.481.0×
smarthealth12$501.87$501.87$501.871.0×
VA Health12$358.48$358.48$358.481.0×
90 degree benefits12$645.26$645.26$645.261.0×
velocity provider ppo network11$3,260.45$3,260.45$3,260.451.0×
haven hospice11$358.48$358.48$358.481.0×
community hospice11$358.48$358.48$358.481.0×
america's choice provider11$3,043.08$3,043.08$3,043.081.0×
prime health services11$3,695.17$3,695.17$3,695.171.0×
quik trip11$3,260.45$3,260.45$3,260.451.0×
usa managed care organization11$3,260.45$3,260.45$3,260.451.0×
Multiplan11$1,200.00$1,200.00$1,200.001.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Ascension St. Vincent DunnBedfordIN23$2,402.50$888.93$336.35$369.23$888.92
Rehabilitation Hospital Of IndianaIndianapolisIN6$4,347.26$4,347.26$1,200.00$3,260.45$3,695.17
Ascension St. Vincent WarrickBoonevilleIN20$3,627.00$2,176.20$50.49$250.13$2,526.21
Ascension St. Vincent JenningsNorth VernonIN20$3,940.00$2,364.00$64.01$250.13$2,631.53
St. Mary Medical Center Inc.HobartIN20$3,627.00$2,176.20$50.49$250.13$2,526.21
Ascension St Vincent Seton SpecialtyIndianapolisIN20$64.01$250.13$652.74
St Vincent Seton Specialty Hosp-LafLafayetteIN20$64.01$250.13$652.74
Ascension St. Vincent WilliamsportWilliamsportIN20$4,265.00$2,559.00$50.49$250.13$2,843.90
Laporte HospitalLaporteIN0$4,628.51$2,499.40
Dukes Memorial HospitalPeruIN0$4,801.00$2,640.55
Margaret Mary Community HospitalBatesvilleIN0$3,136.50$2,634.66
Lutheran Musculoskeletal CenterFort WayneIN0$3,053.00$824.31
Marion General HospitalMarionIN0$1,192.00$715.20
Lutheran Hospital Of IndianaFt WayneIN0$2,807.00$1,010.52
Porter Regional HospitalValparaisoIN0$6,765.00$2,435.40
Good Samaritan HospitalVincennesIN0$1,082.20$1,060.56
Schneck Medical CenterSeymourIN0$3,172.00$2,220.40
Bluffton Regional Medical CenterBlufftonIN0$8,611.00$4,736.05
Dupont HospitalFort WayneIN0$4,184.00$1,882.80

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.