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 cost estimate includes the costs for the facility (place where the procedure was performed, including supplies and staff) and the professional (provider who interprets the MRI).

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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 $4,734
$373 62% $142 Medium
$7,839 91% $706 Medium
Seacoast Dermatology
Portsmouth, NH
$886 0% $886 High
$4,317 57% $1,856 High
$2,174 0% $2,174 Medium
Exeter Hospital
Exeter, NH
$6,223 63% $2,303 High
Concord Hospital
Concord, NH
$7,606 67% $2,510 Medium
$2,808 0% $2,808 Medium
Elliot Hospital
Manchester, NH
$7,178 59% $2,943 High
$3,103 0% $3,103 Medium
$3,380 0% $3,380 Medium
$6,221 37% $3,919 Medium
$3,919 0% $3,919 Medium
$4,538 0% $4,538 Medium
Monadnock Community Hospital
Peterborough, NH
$7,455 38% $4,622 Medium
$7,837 40% $4,702 Medium
Concord Orthopaedics
Concord, NH
$4,734 0% $4,734 Medium
$8,514 33% $5,705 Medium
Memorial Hospital
North Conway, NH
$8,523 33% $5,710 Medium
$7,914 0% $7,914 Medium
$8,822 0% $8,822 Medium
$8,822 0% $8,822 Medium
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