72158

Mri scan of lower spinal canal before and after contrast

Medicare pricing data for 22,393 providers across 52 states

🤖AI Overview

This procedure has a 6.9x markup — hospitals charge $1,073 but Medicare allows only $156.45. Uninsured patients may face bills 6.9 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Mri scan of lower spinal canal before and after contrast (HCPCS code 72158) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $156.45, but hospitals typically charge $1,073 — a 6.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$31.29

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $156.45, your out-of-pocket cost would be approximately $31.29. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$156.45
Average Hospital Charge
$1,073
Markup Ratio
6.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,072.92
Medicare Allowed$156.45
Medicare Payment$121.52

Hospitals charge 6.9x more than what Medicare allows for this procedure. Medicare actually pays $121.52 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$214$51248136+37.0%
New Jersey$205$1,4035184,785+31.1%
Maryland$197$1,0984154,183+26.1%
Florida$188$1,4491,56815,696+20.3%
Alaska$184$1,57977557+17.3%
Connecticut$183$1,1943213,163+17.2%
New York$183$1,2471,17714,586+16.8%
California$182$1,2341,96517,724+16.5%
District of Columbia$180$96561765+15.1%
Alabama$177$1,0044453,949+13.0%
Arizona$176$1,2873753,964+12.2%
Nevada$173$1,1601941,361+10.3%
Massachusetts$164$1,0606167,437+4.9%
Rhode Island$162$955621,008+3.8%
Hawaii$162$72766327+3.6%
Texas$161$1,2541,44315,991+2.6%
Washington$159$8625264,449+1.7%
Wyoming$158$1,16452328+0.8%
Minnesota$156$1,1727126,764-0.1%
Louisiana$154$1,1313872,908-1.6%
Virginia$152$1,3355506,928-3.2%
New Mexico$149$1,229103818-4.9%
South Carolina$149$1,1794274,309-5.1%
Delaware$148$81878894-5.6%
North Carolina$147$1,0968879,014-6.0%
Colorado$147$8433933,729-6.0%
Tennessee$145$1,0046576,021-7.2%
Georgia$144$1,1006626,047-7.7%
Mississippi$142$1,1712092,720-9.4%
Indiana$140$1,0214313,866-10.5%
Oregon$139$8012872,322-11.0%
Utah$139$7751961,659-11.4%
Illinois$138$1,0319609,502-12.0%
Kansas$137$6512442,090-12.2%
Pennsylvania$137$7501,0379,752-12.3%
Maine$136$67289799-13.2%
Iowa$134$7932852,730-14.1%
Kentucky$134$7522492,367-14.4%
Montana$134$67691859-14.5%
Nebraska$132$7291581,913-15.6%
Ohio$130$8287197,456-16.7%
Vermont$128$57837393-18.2%
New Hampshire$128$1,1071611,274-18.4%
Arkansas$127$6332612,655-18.6%
Wisconsin$127$1,3255554,099-18.7%
Missouri$127$6864535,345-19.0%
South Dakota$126$65074813-19.5%
Oklahoma$125$7662442,168-20.4%
Idaho$124$699100857-21.0%
Michigan$122$6735437,674-22.0%
North Dakota$121$59478808-22.6%
West Virginia$112$6251311,206-28.1%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber