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 $5,314
$630 0% $630 Low
$3,142 62% $1,194 Medium
$4,942 67% $1,631 Medium
$3,873 57% $1,666 Medium
Concord Hospital
Concord, NH
$5,959 67% $1,966 High
$2,092 0% $2,092 High
$2,174 0% $2,174 Medium
Exeter Hospital
Exeter, NH
$6,509 63% $2,408 Medium
St. Joseph Hospital
Nashua, NH
$6,522 61% $2,543 High
$8,797 69% $2,727 Medium
Elliot Hospital
Manchester, NH
$7,694 59% $3,155 High
$3,180 0% $3,180 Medium
$3,380 0% $3,380 Medium
$4,007 0% $4,007 High
Orchard Imaging
Salem, NH
$4,116 0% $4,116 Medium
$4,675 0% $4,675 Medium
$7,596 37% $4,785 Medium
$8,243 40% $4,946 High
Concord Orthopaedics
Concord, NH
$5,314 0% $5,314 Low
$5,522 0% $5,522 Medium
$8,960 33% $6,003 High
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