Quick answer
Yes, when your doctor orders it for a medical reason. Health plans cover MRIs as diagnostic imaging, but most require prior approval for scans that aren’t emergencies, and you’ll usually pay toward your deductible and then coinsurance. Where you get the scan matters too: prices can differ a lot between hospitals and independent imaging centers.
Key takeaways
- MRIs are covered when they’re medically necessary, which usually means your doctor orders one to diagnose or monitor a problem.
- Most plans require prior authorization for non-emergency MRIs. Skipping it can get the claim denied. See how prior authorization works.
- Until you meet your deductible, you may pay the plan’s full negotiated price for the scan.
- An in-network imaging center often costs less than a hospital. Your plan’s cost estimator can show the difference.
- Medicare Part B covers MRIs your doctor orders; you pay 20% after the deductible.
On this page
When insurance covers an MRI
Doctors order MRIs to look at the brain, spine, joints, heart and organs in the abdomen, including the kidneys. Your plan will usually cover one when your records show why it’s needed, such as symptoms, an injury that isn’t healing, or a condition that needs monitoring.
For some problems, plans want you to try other steps first. With back or joint pain, that might mean a few weeks of treatment or an X-ray before an MRI. In an emergency, imaging is part of your emergency room care, and plans can’t require prior approval for emergency services.
Prior authorization
Your doctor’s office usually requests approval from your insurer before scheduling the scan. Ask the office to confirm it’s approved before you go.
| Plan type | How fast it must decide a standard request |
|---|---|
| Job-based plans | Within 15 days (72 hours if urgent) |
| Medicare Advantage and Medicaid plans | Within 7 days (72 hours if urgent), since 2026 |
| Original Medicare | Generally no prior approval needed for a scan your doctor orders |
If your request is denied, you can appeal, and your doctor can send more records. See how to appeal a health insurance claim denial.
What you’ll pay
Your cost depends on your deductible, coinsurance and where you go.
- Before you meet your deductible: you usually pay the plan’s full negotiated rate. With a high-deductible plan, that can be the whole bill. See how you meet your deductible.
- After the deductible: you pay coinsurance, a percentage of the cost that depends on your plan and its metal level, until you reach your out-of-pocket maximum.
- Out of network: you may pay much more, or the plan may not pay at all.
Hospitals usually charge more than independent imaging centers for the same scan. Most health plans must offer an online tool that estimates your cost for a service, and hospitals must post their prices. Use both before you book. High prices for things like imaging are one reason health insurance is so expensive.
Your provider usually bills your insurer directly. If you have to send the claim yourself, see how to file a health insurance claim.
Medicare
Part B covers MRIs and other diagnostic imaging your doctor orders. After the Part B deductible ($283 in 2026), you pay 20% of the Medicare-approved amount at a doctor’s office or independent testing facility. At a hospital outpatient department, you pay a copayment instead. For scans outside a hospital, Medicare only pays accredited imaging providers, so check before you go.
What an MRI costs without insurance
Medicare’s 2026 physician fee schedule pays an estimated $195 for a brain MRI without contrast, $192 for a lumbar spine MRI and $204 for a knee MRI. Those amounts cover the scan and the radiologist’s reading at an imaging center or doctor’s office. They’re what Medicare pays, not a cash price, but they give you a floor to compare against.
Private insurers pay a lot more than Medicare. A 2024 RAND study of hospital prices found employers and private insurers paid an average of 279% of Medicare’s rate for hospital outpatient services, the category imaging usually falls under. That ratio varies a lot by state, from under 170% of Medicare in Arkansas to more than 300% in states like California, Florida, New York and Wisconsin. The study covers hospital prices in general, not MRIs alone.
There’s no reliable nationwide figure for what hospitals charge self-pay patients for an MRI. Ranges on consumer cost-estimator sites usually don’t say where their numbers come from, so treat them as rough guesses. To get a real price, ask the facility for its self-pay rate or check its posted prices. Every hospital has to post its prices online, including a consumer-friendly list of “shoppable services,” and starting with 2026, hospitals also have to show the median amount insurers actually paid for each service.
| MRI type | CPT code | Estimated 2026 Medicare payment |
|---|---|---|
| Brain, without contrast | 70551 | $195.40 |
| Lumbar spine, without contrast | 72148 | $191.72 |
| Knee or other lower-extremity joint, without contrast | 73721 | $204.41 |
If you don’t have coverage
Without insurance, ask for the cash price and compare a few imaging centers. You have the right to a written good faith estimate before a scheduled service, and you can dispute the bill if it’s $400 or more over the estimate. See what if you can afford your medical bills out of pocket.
To get covered, see health insurance for individuals, the ACA and how long it takes to get health insurance after applying. If your current insurer makes imaging hard to get, compare others at open enrollment; see the best health insurance companies and how to switch health insurance companies.
Compare plans in your area: see quotes by ZIP code.
Frequently asked questions
Do I need prior authorization for an MRI?
Usually, for non-emergency scans on private plans, Medicare Advantage and Medicaid. Your doctor’s office normally handles the request.
How much does an MRI cost with insurance?
It depends on your deductible, coinsurance and where you go. Check your plan’s cost estimator and compare in-network imaging centers with hospitals.
How much is an MRI without insurance?
There’s no reliable published figure for self-pay MRI prices. Medicare pays an estimated $190 to $205 for a standard scan without contrast in 2026, and private insurers pay hospitals close to three times Medicare’s rates on average. Prices vary a lot between hospitals and imaging centers, so ask for the self-pay rate or check the facility’s posted prices before you schedule.
What if my insurance denies my MRI?
Ask for the reason in writing, have your doctor send more records, and file an appeal. If the internal appeal fails, you can ask for an independent external review.
Does Medicare cover MRIs?
Yes. Part B covers MRIs your doctor orders to diagnose or treat a medical problem.
Sources
- Medicare.gov: Diagnostic non-laboratory tests
- CMS: Interoperability and Prior Authorization Final Rule fact sheet
- U.S. Department of Labor: Filing a claim for your health benefits (PDF)
- CMS: Health plan price transparency
- CMS: No Surprises Act key protections (PDF)
- RAND Corporation: Hospital Price Transparency Study, Round 5
- CMS: Hospital price transparency
This article is general information, not medical advice. Last reviewed September 2026.