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
$342
Average
$2.0k
Median
$1.3k
High
$6.3k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
117 hospitals; the 90th percentile is 14.2× 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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203 hospital rates
iThe hospitals that file a Wellmark 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 | Avera McKennan Hospital Sioux Falls, SD case rate · outpatient | 2 | $1.1k | $1.1k | — | — | 296 | $1.1k – $1.1k |
| 2 | Sanford USD Medical Center Sioux Falls, SD other · outpatient | 1 | $874 | $874 | — | — | 58 | $874 – $874 |
| 3 | Spencer Municipal Hospital Spencer, IA fee schedule · outpatient | 2 | $1.0k | $1.0k | $49 | 5% | 36 | $992 – $1.1k |
| 4 | Avera St. Mary's Hospital Pierre, SD outpatient | 1 | $1.1k | $1.1k | — | — | 24 | $1.1k – $1.1k |
| 5 | Avera St. Mary's Hospital Pierre, SD case rate · outpatient | 1 | $1.1k | $1.1k | — | — | 24 | $1.1k – $1.1k |
| 6 | Avera St. Luke's Aberdeen, SD outpatient | 1 | $996 | $996 | — | — | 23 | $996 – $996 |
| 7 | Avera St. Luke's Aberdeen, SD case rate · outpatient | 1 | $996 | $996 | — | — | 23 | $996 – $996 |
| 8 | Avera Holy Family Hospital Estherville, IA case rate · outpatient | 2 | $4.7k | $4.7k | — | — | 2–20 | $4.7k – $4.7k |
| 9 | Avera Merrill Pioneer Rock Rapids, IA case rate · outpatient | 2 | $4.2k | $4.2k | — | — | 2–20 | $4.2k – $4.2k |
| 10 | Avera Milbank Hospital Milbank, SD outpatient | 1 | $5.3k | $5.3k | — | — | 2–20 | $5.3k – $5.3k |
| 11 | Avera Milbank Hospital Milbank, SD percent of total billed charges · outpatientfrom % of charges | 1 | $3.1k | $3.1k | — | — | 2–20 | $3.1k – $3.1k |
| 12 | Grundy County Memorial Hospital Grundy Center, IA facility · other · outpatient | 2 | $1.1k | $1.1k | $51 | 5% | 2–20 | $1.0k – $1.1k |
| 13 | Lakes Regional Hospital Spirit Lake, IA case rate · outpatient | 2 | $1.1k | $1.1k | — | — | 2–20 | $1.1k – $1.1k |
| 14 | Monument Health Network Inc Deadwood, SD percent of total billed charges · outpatientfrom % of charges | 2 | $3.1k | $3.1k | $1.5k | 47% | 2–20 | $1.6k – $4.6k |
| 15 | Monument Health Network Inc Sturgis, SD percent of total billed charges · outpatientfrom % of charges | 2 | $2.9k | $2.9k | $1.5k | 53% | 2–20 | $1.4k – $4.4k |
| 16 | Monument Health Network Inc Custer, SD percent of total billed charges · outpatientfrom % of charges | 2 | $3.2k | $3.2k | $1.8k | 56% | 2–20 | $1.4k – $5.0k |
| 17 | Pella Regional Health Center Pella, IA other · outpatient | 2 | $942 | $942 | $50 | 5% | 2–20 | $893 – $992 |
| 18 | Regional Health Services of Howard County Cresco, IA case rate · outpatient | 2 | $1.2k | $1.2k | — | — | 2–20 | $1.2k – $1.2k |
| 19 | Sioux Center Health Sioux Center, IA case rate · outpatient | 2 | $1.0k | $1.0k | — | — | 2–20 | $1.0k – $1.0k |
| 20 | Spencer Municipal Hospital Spencer, IA fee schedule · inpatient | 2 | $1.0k | $1.0k | $49 | 5% | 2–20 | $992 – $1.1k |
| 21 | Avera Gregory Hospital Gregory, SD outpatient | 1 | $4.3k | $4.3k | — | — | 1–10 | $4.3k – $4.3k |
| 22 | Avera Gregory Hospital Gregory, SD percent of total billed charges · outpatientfrom % of charges | 1 | $5.3k | $5.3k | — | — | 1–10 | $5.3k – $5.3k |
| 23 | Avera Missouri River Health Center Gettysburg, SD outpatient | 1 | $4.3k | $4.3k | — | — | 1–10 | $4.3k – $4.3k |
| 24 | Avera Missouri River Health Center Gettysburg, SD percent of total billed charges · outpatientfrom % of charges | 1 | $4.3k | $4.3k | — | — | 1–10 | $4.3k – $4.3k |
| 25 | Avera Queen of Peace Mitchell, SD outpatient | 1 | $1.2k | $1.2k | — | — | 1–10 | $1.2k – $1.2k |
← Payers reporting CPT 72158 · Snapshot 20261111T120946Z-9134e7f7