How Much Does an MRI Lumbar Spine Cost in Pennsylvania?
Mri lumbar spine w/o dye
$312Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, an MRI lumbar spine costs up to about $312 in total at a hospital outpatient department, counting both the physician and the facility (national rates). Outside a hospital, at an independent imaging center, lab or office, Medicare's full rate in Pennsylvania averages $190, from $180 in Rest of Pennsylvania to $199 in Metropolitan Philadelphia.
- ✓Your ZIP's wage-adjusted hospital and surgery center rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Pennsylvania Medicare physician rate (2026)
-1.2% vs nationalAverage of 2 localities. Office range $180.03–$198.98.
What the whole procedure costs
The office rate above is what an imaging center, lab or office is paid for the whole test. In a hospital, the facility bills its own fee and the physician bills only the reading. These are 2026 national Medicare amounts.
Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. For a test like this the physician in a hospital bills only the reading (the professional component); outside a hospital one global fee covers the whole test, shown in the office rate above. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Your ZIP in Pennsylvania
Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
What MRI lumbar spine costs at hospitals near you
Everything above is a national average. The hospital you pick in Pennsylvania moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 15001.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Pennsylvania the office and hospital physician lines for this CPT differ by $120.79.
National vs Pennsylvania
Where Pennsylvania ranks for this CPT
CPT 72148 by Pennsylvania locality
| Locality | Office |
|---|---|
| metropolitan philadelphia | $198.98 |
| rest of pennsylvania | $180.03 |
PE GPCI ranges from 0.918 to 1.041 in Pennsylvania. That index is why the same CPT is not one price statewide.
MRI Lumbar Spine and how Pennsylvania is priced
Pennsylvania's fee schedule separates metro Philadelphia from the rest of the state, giving the southeast its own higher-cost locality while Pittsburgh, Harrisburg, Allentown, Erie, and rural Pennsylvania share rest-of-state adjustments. That means the state's second-largest medical market, Pittsburgh, is priced with rural counties rather than with Philadelphia. The Philadelphia locality's premium reflects the metro's wage and rent levels, which lead the state by a wide margin. For patients, the key locality question in Pennsylvania is simply whether care happens in the Philadelphia area.
Philadelphia is one of America's historic centers of academic medicine, dense with teaching hospitals, while Pittsburgh is dominated by a pair of large integrated systems whose rivalry has defined that market for years. The rural middle of the state, sometimes called the T, has far fewer options, and hospital closures there have drawn statewide attention. Residents near the edges use New York, Baltimore, or Ohio providers when convenient.
This procedure: A lumbar spine MRI without contrast images the lower back, the region responsible for most back pain and sciatica, showing discs, nerve roots, and the spinal canal. It is the definitive test before considering injections or surgery for a suspected herniated disc or spinal stenosis. You lie on your back in the scanner for 20 to 40 minutes; it is painless but the flat position can be uncomfortable if lying down aggravates your pain.
What Is MRI Lumbar Spine?
A lumbar spine MRI without contrast images the lower back, the region responsible for most back pain and sciatica, showing discs, nerve roots, and the spinal canal. It is the definitive test before considering injections or surgery for a suspected herniated disc or spinal stenosis. You lie on your back in the scanner for 20 to 40 minutes; it is painless but the flat position can be uncomfortable if lying down aggravates your pain.
What Affects the Cost
- –This is one of the most shopped scans in America, and prices between hospitals and independent centers commonly differ several-fold.
- –Insurer rules pushing six weeks of conservative care first mean therapy visit costs often precede the scan.
- –Findings frequently lead to epidural injections or surgical consultations, so the MRI is often the gateway to a much larger episode of spending.
- –Contrast is only added for specific concerns like prior surgery or infection, at a higher-code price.
- –Open or wide-bore scanners for larger or claustrophobic patients can carry different pricing at specialty centers.
Questions to Ask Before Booking
- 1.Do I meet my insurer's criteria yet, or will this be denied for lack of conservative treatment first?
- 2.What is the cash or negotiated price at nearby freestanding imaging centers?
- 3.Is my scan authorized at the specific location I am booked at?
- 4.Given my history, does the radiologist need contrast, and what would that add?
- 5.If the MRI shows a disc problem, what are the typical next-step costs I should anticipate?
Other featured procedures in Pennsylvania
MRI Lumbar Spine in other states
MRI Lumbar Spine in Pennsylvania: questions
Under 2026 Medicare rates, an MRI lumbar spine costs up to about $312 in total at a hospital outpatient department, counting both the physician and the facility (national rates). Outside a hospital, at an independent imaging center, lab or office, Medicare's full rate in Pennsylvania averages $190, from $180 in Rest of Pennsylvania to $199 in Metropolitan Philadelphia. Enter a ZIP for the exact Pennsylvania locality.
Yes. CMS splits Pennsylvania into 2 payment localities. For this CPT the office physician fee spans $18.95 from the lowest to highest locality. Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $38 for the office physician line or $14 for the hospital physician line in Pennsylvania. Medigap may cover that 20%. This is not the hospital facility fee.
It depends on where the test is done. At an independent imaging center, lab or office, $189.51 is Medicare's full rate in Pennsylvania, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $68.72) and the hospital is paid separately, which brings the national total to up to about $312. Pennsylvania ranks #28 of 51 states on the non-hospital rate (within 2% of the national office rate of $191.72).