CPT
70450 — CT scan of head/brain without contrast
Same scan can cost 5x more at a hospital than at an imaging center.
Imaging
72158 — MRI spinal canal and contents, lumbar; without and with contrast material
An MRI of the lower spine that is performed in two phases — first without contrast dye, then again after contrast is injected — to better evaluate post-surgical changes, infection, tumors, or inflammatory conditions.
- Typical setting: Hospital, imaging center
- National avg charge (illustrative): $350–$750 Medicare allowed; $500–$2,000 commercial; varies by region
- Most-disputed reason: Billing 72148 (without contrast) and 72149 (with contrast) separately instead of the single combined code 72158 when both phases were performed in a single session
What it means
What 72158 actually means
An MRI of the lower spine that is performed in two phases — first without contrast dye, then again after contrast is injected — to better evaluate post-surgical changes, infection, tumors, or inflammatory conditions. The addition of contrast helps distinguish between scar tissue and recurrent disc herniation after spinal surgery.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Billing 72148 (without contrast) and 72149 (with contrast) separately instead of the single combined code 72158 when both phases were performed in a single session
- Billing 72158 with modifier 59 for additional MRI sequences as if they were separate studies — additional sequences are included in 72158
- Unbundling professional from technical component without appropriate billing arrangement
If you see 72158 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 72158 often also see these adjacent codes on the same bill.
CPT
70470 — CT head/brain with and without contrast
If contrast wasn't given, 70470 is the wrong code.
CPT
70486 — CT maxillofacial area; without contrast material
Imaging — verify professional + technical components weren't double-billed.
CPT
70551 — MRI brain without contrast
Same scan can be 5x cheaper at a freestanding imaging center.
CPT
71045 — Chest X-ray, single view
Same image can cost 10x more at a hospital than a freestanding imaging center.
CPT
71046 — Chest X-ray, two views (PA + lateral)
Two-view CXR is standard. Watch the price gap between hospital and freestanding.
Related BillBusted guides
Plain-English reads if you see 72158 on a bill.
72158 FAQ
Plain-English answers.
What does 72158 usually cost?
$350–$750 Medicare allowed; $500–$2,000 commercial; varies by region. Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 72158?
Billing 72148 (without contrast) and 72149 (with contrast) separately instead of the single combined code 72158 when both phases were performed in a single session
What should I do if I see 72158 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 72158 before paying.
Don't pay 72158 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.