MRI machines and radiologist reads are both expensive. These are among the largest areas of medical spending for most health plans (and those costs are largely

MRI machines and radiologist reads are both expensive. These are among the largest areas of medical spending for most health plans (and those costs are largely passed on to subscribers and employers). Many rotator cuff injuries do improve to some extent with targeted physical therapy. You can accomplish a lot by strengthening the stabilizer muscles, and by learning how to set your shoulder joint in the correct position before taking a load. So the insurer's position is reasonable for most cases. If the injury is more severe then your doctor can submit a request to skip the normal step therapy process.