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-LUBR SPNE W/O CONTR & W/
Teaneck, NJ
See all hospitals reporting CPT 72158 →Price type
Holy Name’s median price of $1.3k is 50% above the median hospital's median price ($865), higher than 64% of the 2,603 hospitals reporting CPT 72158. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 21 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna medicare prime facility · fee schedule · outpatient | $379 | $379 | — | — | — | $379 – $379 |
| 2 | Aetna golden medicare facility · fee schedule · outpatient | $421 | $421 | — | — | — | $421 – $421 |
| 3 | Clover clover facility · fee schedule · outpatient | $421 | $421 | — | — | — | $421 – $421 |
| 4 | UnitedHealthcare medicare facility · fee schedule · outpatient | $421 | $421 | — | — | — | $421 – $421 |
| 5 | WellCare medicare facility · fee schedule · outpatient | $425 | $425 | — | — | — | $425 – $425 |
| 6 | UnitedHealthcare medicaid facility · percent of total billed charges · outpatientfrom % of charges | $686 | $686 | $127 | 18% | — | $559 – $812 |
| 7 | Aetna whole health facility · fee schedule · outpatient | $717 | $717 | — | — | — | $717 – $717 |
| 8 | Aetna better health mcd/chip facility · percent of total billed charges · outpatientfrom % of charges | $720 | $720 | $133 | 18% | — | $587 – $853 |
| 9 | UnitedHealthcare uhc facility · other · outpatient | $810 | $810 | — | — | — | $810 – $810 |
| 10 | Aetna qualified health plans facility · percent of total billed charges · outpatientfrom % of charges | $824 | $824 | $152 | 18% | — | $672 – $977 |
| 11 | Ambetter ambetter facility · percent of total billed charges · outpatientfrom % of charges | $1.1k | $1.1k | $198 | 18% | — | $875 – $1.3k |
| 12 | Cigna hmo/pos facility · fee schedule · outpatient | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 13 | Aetna hmo/pos facility · percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | $267 | 18% | — | $1.2k – $1.7k |
| 14 | First Health first health facility · percent of total billed charges · outpatientfrom % of charges | $2.1k | $2.1k | $379 | 18% | — | $1.7k – $2.4k |
| 15 | Aetna worker's comp facility · percent of total billed charges · outpatientfrom % of charges | $2.6k | $2.6k | $484 | 18% | — | $2.1k – $3.1k |
| 16 | MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges | $2.8k | $2.8k | $515 | 18% | — | $2.3k – $3.3k |
| 17 | MultiPlan worker's comp facility · percent of total billed charges · outpatientfrom % of charges | $3.6k | $3.6k | $674 | 18% | — | $3.0k – $4.3k |
| 18 | MultiPlan auto accident medical facility · percent of total billed charges · outpatientfrom % of charges | $3.9k | $3.9k | $714 | 18% | — | $3.1k – $4.6k |
| 19 | Blue Cross Blue Shield indemnity facility · percent of total billed charges · outpatientfrom % of charges | $4.0k | $4.0k | $735 | 18% | — | $3.2k – $4.7k |
| 20 | Blue Cross Blue Shield managed facility · percent of total billed charges · outpatientfrom % of charges | $4.0k | $4.0k | $735 | 18% | — | $3.2k – $4.7k |
| 21 | Blue Cross Blue Shield ppo facility · percent of total billed charges · outpatientfrom % of charges | $4.0k | $4.0k | $735 | 18% | — | $3.2k – $4.7k |
Last updated: Nov 10, 2025
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