Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
MRI Spinal Canal Lumbar W/O & W/Contr Matrl
Low
$49
Average
$606
Median
$351
High
$8.9k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
350 hospitals; the 90th percentile is 3.7× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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388 hospital rates
iThe hospitals that file a Tricare rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient | 1 | $315 | $315 | — | — | 13 | $315 – $315 |
| 2 | PRISMA HEALTH TUOMEY HOSPITAL SUMTER, SC other · both | 1 | $334 | $334 | — | — | 11 | $334 – $334 |
| 3 | Benefis Hospitals Inc Helena, MT other · outpatient | 1 | $357 | $357 | — | — | 2–20 | $357 – $357 |
| 4 | Brigham and Women's Faulkner Hospital Boston, MA other · both | 1 | $403 | $403 | — | — | 1–10 | $403 – $403 |
| 5 | Brigham and Women's Hospital Boston, MA other · both | 1 | $403 | $403 | — | — | 1–10 | $403 – $403 |
| 6 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $1.7k | $1.7k | — | — | 1–10 | $1.7k – $1.7k |
| 7 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · other · outpatient | 1 | $453 | $453 | — | — | 1–10 | $453 – $453 |
| 8 | Mercy Hospital Fort Smith Smith, AR facility · other · outpatient | 1 | $331 | $331 | — | — | 1–10 | $331 – $331 |
| 9 | Mercy Hospital Fort Smith Smith, AR facility · other · outpatient | 1 | $331 | $331 | — | — | 1–10 | $331 – $331 |
| 10 | Mercy Hospital Lebanon dba Mercy Hospital Lebanon Rolla, MO facility · other · outpatient | 1 | $367 | $367 | — | — | 1–10 | $367 – $367 |
| 11 | Mercy Hospital Oklahoma City Inc City, OK facility · other · outpatient | 1 | $314 | $314 | $8 | 3% | 1–10 | $306 – $323 |
| 12 | Mercy Hospital Rogers dba Mercy Hospital Northwest Arkansas Rogers, AR facility · other · outpatient | 1 | $319 | $319 | — | — | 1–10 | $319 – $319 |
| 13 | Mercy Hospital Springfield Ozark, MO facility · other · outpatient | 1 | $343 | $343 | — | — | 1–10 | $343 – $343 |
| 14 | Mercy Hospital Springfield Springfield, MO facility · other · outpatient | 1 | $343 | $343 | — | — | 1–10 | $343 – $343 |
| 15 | Mercy St. Francis Hospital View, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.3k | $1.3k | — | — | 1–10 | $1.3k – $1.3k |
| 16 | OKTIBBEHA COUNTY HOSPITAL STARKVILLE, MS other · outpatient | 1 | $301 | $301 | — | — | 1–10 | $301 – $301 |
| 17 | PRISMA HEALTH BAPTIST COLUMBIA HOSPITAL COLUMBIA, SC other · both | 1 | $330 | $330 | — | — | 1–10 | $330 – $330 |
| 18 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC other · both | 1 | $333 | $333 | — | — | 1–10 | $333 – $333 |
| 19 | PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC other · both | 1 | $335 | $335 | — | — | 1–10 | $335 – $335 |
| 20 | PRISMA HEALTH BLOUNT MEMORIAL HOSPITAL MARYVILLE, TN other · both | 1 | $333 | $333 | — | — | 1–10 | $333 – $333 |
| 21 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC other · both | 1 | $333 | $333 | — | — | 1–10 | $333 – $333 |
| 22 | PRISMA HEALTH GREER MEMORIAL HOSPITAL GREER, SC other · both | 1 | $332 | $332 | — | — | 1–10 | $332 – $332 |
| 23 | PRISMA HEALTH PATEWOOD HOSPITAL GREENVILLE, SC other · both | 1 | $332 | $332 | — | — | 1–10 | $332 – $332 |
| 24 | PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC other · both | 1 | $335 | $335 | — | — | 1–10 | $335 – $335 |
| 25 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER GRENADA, MS other · outpatient | 1 | $301 | $301 | — | — | 1–10 | $301 – $301 |
← Payers reporting CPT 72158 · Snapshot 20261111T120946Z-9134e7f7