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
HC MRI SPINE LUMBAR W WO CONTRAST
Darlington, WI
See all hospitals reporting CPT 72158 →Price type
Lafayette County’s median price of $2.0k is 134% above the median hospital's median price ($874), higher than 77% of the 2,651 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: 4 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 advantage professional · fee schedule · both | $117 | $117 | — | — | — | $117 – $117 |
| 2 | Anthem commercial professional · fee schedule · both | $117 | $117 | — | — | — | $117 – $117 |
| 3 | Anthem medicare advantage professional · fee schedule · both | $117 | $117 | — | — | — | $117 – $117 |
| 4 | Humana commercial professional · fee schedule · both | $117 | $117 | — | — | — | $117 – $117 |
| 5 | Humana medicare advantage professional · fee schedule · both | $117 | $117 | — | — | — | $117 – $117 |
| 6 | UnitedHealthcare medicare advantage professional · fee schedule · both | $117 | $117 | — | — | — | $117 – $117 |
| 7 | Anthem badgercare professional · fee schedule · both | $135 | $135 | — | — | — | $135 – $135 |
| 8 | UnitedHealthcare badgercare professional · fee schedule · both | $135 | $135 | — | — | — | $135 – $135 |
| 9 | UnitedHealthcare commercial professional · fee schedule · both | $153 | $153 | — | — | — | $153 – $153 |
| 10 | UnitedHealthcare medicare advantage facility · other · inpatient | $694 | $694 | — | — | 1–10 | $694 – $694 |
| 11 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 12 | Anthem medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 13 | Humana medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | — | — | 1–10 | $2.0k – $2.0k |
| 14 | UnitedHealthcare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | — | — | 1–10 | $2.0k – $2.0k |
| 15 | Humana medicare advantage facility · other · inpatient | $2.1k | $2.1k | — | — | 1–10 | $2.1k – $2.1k |
| 16 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 17 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 18 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 19 | Anthem commercial facility · percent of total billed charges · outpatientfrom % of charges | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 20 | Humana commercial facility · percent of total billed charges · inpatientfrom % of charges | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 21 | Humana commercial facility · percent of total billed charges · outpatientfrom % of charges | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
Last updated: Feb 4, 2026
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