CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Oro Valley Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $575
  • Cash Discount Price: $4,364
  • vs. Medicare Baseline: 2.36x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Oro Valley Hospital is $575. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,364. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.36x the Medicare baseline. Located in 1551 East Tangerine Road, Oro Valley, AZ.
Cash / Self-Pay
$4,364

Average discount available for prompt cash payment at this facility.

Insurance Median
$575

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: $4,364 (1790%)
Insurance Median: $575 (236%)
Cash: $4,364 (1790% of Medicare)
Ins. Median: $575 (236% 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 236% of the Medicare baseline (a markup of 136%). 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
Medicaid / KanCare $165 - $265 68%
Magellan $173 - $11,636 71%
Aetna $181 - $3,685 74%
Veterans Eval Services $235 - $471 96%
Caremore Health Plan $251 - $553 103%
Cigna $251 - $1,125 103%
Humana $251 - $553 103%
Medicare (plans) $251 - $553 103%
Scan Health $251 - $553 103%
UnitedHealthcare $251 - $1,327 103%
Pascua Yaqui Tribe $252 - $556 103%
Blue Cross Blue Shield $255 - $2,967 105%
Department Of Veterans Affairs $255 - $562 105%
Node Non Par Hospice Agree $255 - $562 105%
Node Triwest $255 - $562 105%
Node Va $255 - $562 105%
Tricare $255 - $562 105%
Fresenius Health $256 - $564 105%
Clover Health Mcr Adv $257 - $567 105%
Node Devoted Health Mcr Adv $258 - $569 106%
Node Banner Mcr Adv $263 - $580 108%
Wellcare Mcr Adv $263 - $580 108%
Node Us Dept Of Labor $318 - $702 130%
Ambetter / Centene $359 - $792 147%
Node Health Choice Exchange $379 - $837 155%
Node Fusion Network $458 - $1,011 188%
Node J Allen Inmate Health Svcs $484 - $1,067 199%
Health Net $535 - $1,180 219%
Seven Corners $586 - $1,292 240%
Self Pay $2,327 - $8,145 955%
Beacon Health Options $4,848 - $9,697 1989%
Mtc $4,848 - $9,697 1989%
First Health Coventry $5,091 - $10,182 2088%
Coventry Work Comp Al $5,818 - $11,636 2387%
Multiplan $8,049 - $16,097 3302%
Prime Health $8,242 - $16,485 3381%
Three Rivers $8,242 - $16,485 3381%
Healthsmart $8,727 - $17,455 3580%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1551 East Tangerine Road, Oro Valley, AZ 85755
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals