CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Baldwin Health

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $809
  • Cash Discount Price: $1,551
  • vs. Medicare Baseline: 3.32x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Baldwin Health is $809. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,551. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.32x the Medicare baseline. Located in 1613 North McKenzie Street, Foley, AL.
Cash / Self-Pay
$1,551

Average discount available for prompt cash payment at this facility.

Insurance Median
$809

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $1,551 (636%)
Insurance Median: $809 (332%)
Cash: $1,551 (636% of Medicare)
Ins. Median: $809 (332% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 332% of the Medicare baseline (a markup of 232%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Veterans Eval Services $210 - $419 86%
Tricare $215 - $474 88%
Triwest $222 - $489 91%
Blue Cross Blue Shield $223 - $527 91%
Humana $223 - $491 91%
Medicare (plans) $223 - $491 91%
UnitedHealthcare $223 - $699 91%
Windsor Health Plan $223 - $491 91%
Community Hospice $226 - $499 93%
Hospice $226 - $499 93%
Mercy Medical Hospice $226 - $499 93%
Node Champva $226 - $499 93%
Node Va $226 - $499 93%
Cigna $227 - $1,910 93%
Node Devoted Health Mcr Adv $227 - $501 93%
Aetna $229 - $8,458 94%
Node Clover Health Mcr Adv $229 - $504 94%
Select Health $229 - $504 94%
Node Wellcare Mcr Adv $231 - $509 95%
Us Dol $283 - $624 116%
Ambetter / Centene $340 - $749 139%
First Choice $367 - $809 151%
Medicaid / KanCare $375 154%
Alamed $750 308%
Self Pay $846 - $2,819 347%
American Employee Alliance $1,880 - $3,759 771%
Multiplan $2,678 - $7,706 1099%
First Health $3,524 - $7,589 1446%
Multiplan Inc $3,595 - $7,189 1475%
Coventry Work Comp Al $3,674 - $7,349 1507%
One Health $3,759 - $7,518 1542%
Pro America $3,759 - $7,518 1542%
Novanet $3,794 - $7,589 1556%
Alabama Wc $3,994 - $7,988 1638%
Gulf Health $3,994 - $7,988 1638%
Principal Ppo $3,994 - $7,988 1638%
Viva Health $3,994 - $7,988 1638%
National Health $4,229 - $8,458 1735%
Galaxy $4,276 - $8,552 1754%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1613 North McKenzie Street, Foley, AL 36535
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals