CPT 72158 Radiology

How Much Does Mri lumbar spine w/o & w/dye Cost?

Mri lumbar spine w/o & w/dye (CPT 72158) costs $318 at Medicare rates. Hospital outpatient rate: $356.

Medicare (Facility)
$318
CMS PFS 2026 national rate
Hospital Outpatient
$356
OPPS rate
Surgery Center (ASC)
$193
Ambulatory surgery center

Mri lumbar spine w/o & w/dye Cost by Location

Medicare-adjusted rates across CMS localities

Location Medicare Rate Est. Commercial
AK — ALASKA $370 $482 — $741
AL — ALABAMA $288 $374 — $575
AR — ARKANSAS $284 $369 — $567
AZ — ARIZONA $312 $405 — $623
CA — BAKERSFIELD $342 $445 — $684
CA — CHICO $342 $444 — $683
CA — EL CENTRO $342 $444 — $683
CA — FRESNO $342 $444 — $683
CA — HANFORD-CORCORAN $342 $444 — $683
CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) $365 $475 — $730
CA — MADERA $342 $444 — $683
CA — MERCED $342 $444 — $683
CA — MODESTO $342 $444 — $683
CA — NAPA $398 $518 — $796
CA — OXNARD-THOUSAND OAKS-VENTURA $364 $473 — $727
CA — REDDING $342 $444 — $683
CA — REST OF CALIFORNIA $342 $444 — $683
CA — RIVERSIDE-SAN BERNARDINO-ONTARIO $343 $447 — $687
CA — SACRAMENTO-ROSEVILLE-FOLSOM $359 $467 — $718
CA — SALINAS $358 $465 — $716
CA — SAN DIEGO-CHULA VISTA-CARLSBAD $367 $477 — $733
CA — SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) $422 $549 — $845
CA — SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) $422 $549 — $844
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) $432 $561 — $863
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) $431 $560 — $862

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

2.23
Work RVU
7.14
Practice Expense RVU
0.16
Malpractice RVU
9.53
Total RVU

Payment = Total RVU (9.53) x CF ($33.40) = $318

Frequently Asked Questions

How much does Mri lumbar spine w/o & w/dye cost?

The Medicare facility rate for Mri lumbar spine w/o & w/dye is $318. In a hospital outpatient setting, the rate is $356. At an ambulatory surgery center, the rate is $193. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Mri lumbar spine w/o & w/dye cost without insurance?

Without insurance, the cost of Mri lumbar spine w/o & w/dye can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Mri lumbar spine w/o & w/dye?

Most commercial health insurance plans and Medicare cover Mri lumbar spine w/o & w/dye when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.