Low Back MRI, Before and After Contrast

CPT Code 72158

A diagnostic procedure using magnetic resonance imaging (MRI) of the lumbar spinal canal and contents, first without contrast material and again with contrast material. This event consists of a number of health care services that often occur at the same time. The cost shown reflects the services provided bundled into one cost estimate.

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Provider NameSort by Provider Name Estimate of Procedure Cost Estimate of Procedure Cost
This is an estimate of the total charge for the health care service before any discounts provided to the uninsured.
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Uninsured Discount Uninsured Discount
The minimum discount rate that the health care provider gives to the New Hampshire Insurance Department. The actual discount depends on your financial status and the health care provider’s charity care policy.
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What You Will Pay What You Will Pay
The estimated charge amount minus the uninsured discount (when available).
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Typical Patient Complexity Typical Patient Complexity
This indicates how healthy or sick the patients are that receive care for this procedure at this health care provider. Some health care providers see patients that have more complex health issues or are less healthy than others, and it may be more expensive to treat them.
Statewide Averages $6,179
$7,741 91% $697 Medium
$5,161 65% $1,806 High
Seacoast Dermatology
Portsmouth, NH
$2,003 0% $2,003 Medium
$2,174 0% $2,174 High
Exeter Hospital
Exeter, NH
$6,085 63% $2,251 Medium
$7,573 69% $2,348 Medium
St. Joseph Hospital
Nashua, NH
$6,482 61% $2,528 High
Concord Hospital
Concord, NH
$7,734 67% $2,552 High
Elliot Hospital
Manchester, NH
$6,872 59% $2,818 High
$7,851 62% $2,983 High
$7,906 62% $3,004 Medium
New London Hospital
New London, NH
$5,977 45% $3,287 Medium
$3,390 0% $3,390 Medium
$3,415 0% $3,415 Medium
$4,116 0% $4,116 High
$7,002 37% $4,411 Medium
Monadnock Community Hospital
Peterborough, NH
$7,250 38% $4,495 High
Concord Orthopaedics
Concord, NH
$4,610 0% $4,610 Medium
$4,681 0% $4,681 High
$7,022 0% $7,022 Medium
$11,835 40% $7,101 Medium
$7,552 0% $7,552 Medium
$7,667 0% $7,667 Medium
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