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#2095 of 11K

72157

MRI of lumbar spine without then with contrast

MRI of lumbar spine without then with contrast is the #2,095 most-billed Medicaid procedure code, with $9.1M in payments across 51K claims from 2018–2024. The national median cost per claim is $92.24. Costs vary widely — the 90th percentile is $447.59 per claim, 4.9× the median.

Total Paid

$9.1M

0.00% of all spending

Total Claims

51K

Providers

189

Avg Cost/Claim

$176

National Cost Distribution

How much do providers bill per claim for 72157? Based on 186 providers billing this code nationally.

Median

$92.24

Average

$182.11

Std Dev

$221.77

Max

$1,486.66

Percentile Distribution (Cost per Claim)

p10
$46.80
p25
$63.01
Median
$92.24
p75
$189.29
p90
$447.59
p95
$591.21
p99
$978.06

50% of providers bill between $63.01 and $189.29 per claim for this code.

90% bill between $46.80 and $447.59.

Top 1% bill above $978.06.

About This Procedure

HCPCS code 72157 (MRI of lumbar spine without then with contrast) was billed by 189 providers across 51K claims, totaling $9.1M in Medicaid payments from 2018–2024. This code was used for 49K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$92.24

Providers Billing

186

National Spending

$9.1M

Avg/Median Ratio

1.97×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 72157

#ProviderTotal Paid
1Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$1.1M
2Stanford Health Care

Stanford, CA · General Acute Care Hospital

$1.0M
3State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$485K
4Childrens Hospital Of Los Angeles

Los Angeles, CA · Case Manager/Care Coordinator

$455K
5Dignity Health

Phoenix, AZ · Rehabilitation Unit

$425K
6Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$369K
7Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$328K
81740283324$287K
9University Of Kentucky

Lexington, KY · General Acute Care Hospital

$281K
101871528026$231K
111477549756$221K
12Beverly Radiology Medical Group Iii

Los Angeles, CA · Radiology, Diagnostic Radiology

$214K
13Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$198K
14Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$166K
15Memorial Hospital For Cancer And Allied Diseases

New York, NY · Pharmacy

$164K
16Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$143K
17Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$134K
18Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$117K
191508942681$117K
20Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$115K

Showing top 20 of 189 providers billing this code