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 $5,340
$3,637 62% $1,382 High
Dartmouth Health
Lebanon, NH
$1,819 0% $1,819 Medium
Concord Hospital
Concord, NH
$5,557 67% $1,834 Medium
$2,174 0% $2,174 Medium
$5,396 57% $2,320 Medium
$6,808 63% $2,519 Medium
St. Joseph Hospital
Nashua, NH
$6,522 61% $2,543 Medium
$9,291 69% $2,880 Medium
$5,167 40% $3,100 High
$3,276 0% $3,276 Medium
$3,380 0% $3,380 Medium
Orchard Imaging
Salem, NH
$4,116 0% $4,116 Medium
$4,675 0% $4,675 Medium
$7,934 37% $4,998 Low
$8,570 40% $5,142 High
$9,422 33% $6,313 High
$6,748 0% $6,748 High
$8,395 0% $8,395 High
$9,904 0% $9,904 Medium
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