Getting an MRI starts with a referral from a doctor or other licensed healthcare provider who documents why the scan is medically necessary. From there, the process involves insurance approval, safety screening, and preparation before you ever lie down in the scanner. Here’s what each step looks like in practice.
Getting a Referral
You can’t walk into an imaging center and order your own MRI. A treating physician or qualified practitioner must order it, and they need to document the medical reason. That documentation typically includes your symptoms, physical exam findings, relevant lab results, and any prior treatments that failed to resolve the issue. Without this paper trail, insurance companies (and Medicare) will deny the claim as not “reasonable and necessary.”
If you believe you need an MRI but your doctor hasn’t suggested one, bring it up directly. Describe your symptoms clearly and ask whether imaging would help narrow down a diagnosis. Primary care doctors, specialists, urgent care physicians, and some nurse practitioners and physician assistants can all place the order, depending on your state’s scope-of-practice rules.
Insurance Approval and Prior Authorization
Most insurance plans cover MRIs at least partially, but many require prior authorization before the scan can be scheduled. This means your doctor’s office submits a request to your insurer explaining why the scan is needed, along with supporting clinical notes. The insurer reviews it and either approves, denies, or asks for more information.
This process can take anywhere from a day to a couple of weeks. Delays often happen because of incomplete paperwork. Your doctor’s office should submit signed, finalized visit notes (not drafts), include evidence of medical necessity, and note any prior treatments that didn’t work. If a request gets flagged for a peer-to-peer review, your doctor may need to speak directly with the insurance company’s clinical reviewer to clarify the case. If the request is denied, your doctor can call to find out exactly what documentation is missing and resubmit.
Medicare Part B covers 80% of authorized MRI costs, leaving you responsible for the remaining coinsurance plus any deductible. Private insurance coverage varies by plan, and some employer plans cover 100% of imaging costs. Call your insurer before scheduling to understand your specific out-of-pocket responsibility.
What an MRI Costs
MRI prices in the U.S. range from $400 to $12,000, with a national average around $1,325. A commonly cited “fair price” target is $750. Where you get the scan matters enormously: hospital-based imaging centers tend to charge significantly more than freestanding outpatient facilities for the identical scan on identical equipment.
If you’re uninsured, expect to pay roughly $2,000 out of pocket. Programs like Radiology Assist offer discounted rates for underinsured patients. Many imaging centers also post cash-pay prices that are lower than their billed insurance rates, so it’s worth calling a few places to compare. Ask specifically for the self-pay or cash price, not the chargemaster rate.
Safety Screening
Before your scan, you’ll fill out a detailed safety questionnaire. MRI machines use extremely powerful magnets, and certain metal implants or devices inside your body can be dangerous in that environment. Pacemakers, implantable defibrillators, pacing wires, and some types of loop recorders are among the most common concerns. Coronary stents, certain surgical clips, and metallic fragments (from welding or shrapnel injuries, for example) also require careful evaluation.
Some implants are labeled “MRI conditional,” meaning they’re safe under specific conditions like a certain magnetic field strength. Others are absolute contraindications. The imaging center will review your medical history and may contact your surgeon or check implant records to verify compatibility. If there’s any uncertainty about a device, the scan will be postponed until it can be confirmed safe.
Pregnancy
If you’re pregnant, an MRI can be performed at any stage. Current data has not documented harmful effects on a developing fetus at the magnetic field strengths used in clinical scanning (1.5T and 3T). That said, the scan should still offer a clear diagnostic benefit. The decision is made on a case-by-case basis by the radiologist and your referring provider.
Kidney Function and Contrast
Some MRIs require a contrast agent injected into a vein to make certain tissues or blood vessels more visible. These agents are gadolinium-based and are generally well tolerated, but they carry risks for people with significantly reduced kidney function. If your kidneys are working at a very low level (stage 4 or 5 kidney disease) or you’re on dialysis, certain contrast agents are contraindicated entirely. For people with mild to moderate kidney issues (stages 1 through 3), no special precautions are typically needed. Your doctor may order a blood test to check kidney function before scheduling a contrast-enhanced scan.
How to Prepare for the Scan
Preparation depends on the type of MRI. For abdominal or pelvic scans, you may be asked to fast for several hours beforehand. For brain, spine, or joint imaging, fasting usually isn’t required. Your imaging center will give you specific instructions when you schedule.
Plan to change into a hospital gown. The American College of Radiology has found that some fibers in street clothing can heat up during scanning, potentially causing skin burns. Most facilities require you to remove all clothing, including undergarments, and change into provided gowns, shorts, or pants. Refusing to change will likely mean your exam gets rescheduled. Leave jewelry, watches, hair clips, and anything with metal at home or in a locker.
What Happens During the Scan
You’ll lie on a padded table that slides into a large, tube-shaped magnet. The machine is loud, producing rhythmic knocking and buzzing sounds, so you’ll be given earplugs or headphones. A technologist will communicate with you through an intercom and can see you on a monitor at all times. You’ll also have a call button to squeeze if you need to stop.
The most important thing you’ll need to do is hold still. Even small movements can blur the images and require portions of the scan to be repeated. For brain and spine exams, expect about 45 minutes in the machine. Joint scans (knee, ankle, wrist, elbow, hip) run shorter, typically 25 to 45 minutes. Body scans take 45 to 60 minutes. Cardiac MRIs are the longest, sometimes running 90 minutes to two hours because of the added complexity of capturing a beating heart and breathing motion. If contrast is needed, add about 15 minutes to any of those estimates.
Options for Claustrophobia or Anxiety
Claustrophobia is one of the most common reasons people struggle with MRIs. If you know you’re anxious in enclosed spaces, tell your doctor and the imaging center when you schedule. Several options can help.
- Oral sedation: Your referring doctor can prescribe a mild anti-anxiety medication to take before arriving. You’ll need someone to drive you home afterward.
- IV sedation: For more significant anxiety or for patients who can’t stay still due to pain, some imaging centers offer intravenous sedation administered by an anesthesiologist. These medications act quickly and wear off fast, but you’ll still need a ride home and a short recovery period on-site.
- Wide-bore or open MRI machines: These have a larger opening than standard scanners, which reduces the feeling of confinement. Not every facility has one, and image quality can sometimes differ, so ask your doctor whether this option works for your specific scan.
Getting Your Results
A radiologist reviews your images and sends a report to the doctor who ordered the scan. This typically takes one to three business days, though some centers offer faster turnaround. Your referring doctor will then discuss the findings with you and recommend next steps if anything needs attention. Many health systems now post imaging reports to online patient portals, so you may see the results before your doctor calls. If the report contains unfamiliar terminology, wait to discuss it with your provider rather than trying to interpret it yourself.