CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Grandview Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $2,261
  • Cash Discount Price: $1,763
  • vs. Medicare Baseline: 9.28x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Grandview Medical Center is $2,261. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,763. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.28x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$1,763

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,261

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: $1,763 (723%)
Insurance Median: $2,261 (928%)
Cash: $1,763 (723% of Medicare)
Ins. Median: $2,261 (928% 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 928% of the Medicare baseline (a markup of 828%). 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
Encompass Health $136 56%
Tricare $207 85%
Veterans Eval Services $210 86%
Blue Advantage $215 88%
Humana $215 88%
Medicare (plans) $215 88%
UnitedHealthcare $215 - $4,069 88%
Victory Health $215 88%
Viva Health $215 - $4,974 88%
Select Health $217 89%
Hospice $218 89%
Node Champva $218 89%
Node Va $218 89%
Cigna $219 - $387 90%
Node Devoted Health Mcr Adv $219 90%
Node Clover Health Mcr Adv $220 90%
Aetna $221 - $2,514 91%
Node Wellcare Mcr Adv $223 91%
Node Us Dept Of Labor $273 112%
Ambetter / Centene $327 134%
Medicaid / KanCare $375 154%
Healthspring $382 157%
Blue Cross Blue Shield $439 180%
Choicecare $1,000 410%
Alamed $1,332 546%
Self Pay $1,356 - $2,170 556%
Bp Health Advocate $2,261 928%
Ag Administrators $3,165 1298%
Drummond $3,165 1298%
First Health $3,500 - $7,072 1436%
American Employee Alliance $3,617 1484%
Healthchoice $4,522 - $5,426 1855%
Value Options $4,522 1855%
Multiplan $5,516 - $6,330 2263%
Blue Bell Creameries $6,330 2597%
Natl Comp Care $6,782 2782%
Usa Ppo $6,782 2782%
Coventry Work Comp Al $7,072 2901%
Novanet $7,302 2995%
Alabama Wc $7,687 3153%
Cal-Med $7,687 3153%
Corvel $7,687 3153%
Associated Admin $8,139 3339%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals