CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Northwest Medical Center Sahuarita

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $539
  • Cash Discount Price: $3,636
  • vs. Medicare Baseline: 2.21x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Northwest Medical Center Sahuarita is $539. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,636. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.21x the Medicare baseline. Located in 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ.
Cash / Self-Pay
$3,636

Average discount available for prompt cash payment at this facility.

Insurance Median
$539

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: $3,636 (1492%)
Insurance Median: $539 (221%)
Cash: $3,636 (1492% of Medicare)
Ins. Median: $539 (221% 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 221% of the Medicare baseline (a markup of 121%). 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%
Mercy Care $165 - $553 68%
Aetna $181 - $553 74%
Blue Cross Blue Shield $251 - $2,599 103%
Cigna $251 - $1,125 103%
Humana $251 - $553 103%
Medicare (plans) $251 - $553 103%
Node Caremore Mcr Adv $251 - $553 103%
Node Mercy Care Mcr Adv $251 - $553 103%
UnitedHealthcare $251 - $1,051 103%
Department Of Veterans Affairs $255 - $562 105%
Node Champva $255 - $562 105%
Node Non Par Hospice Agree $255 - $562 105%
Node Triwest $255 - $602 105%
Node Va $255 - $562 105%
Tricare $255 - $562 105%
Node Clover Health Mcr Adv $257 - $567 105%
Node Devoted Health Mcr Adv $258 - $569 106%
Banner Mcr Adv $263 - $580 108%
Node Banner Mcr Adv $263 - $580 108%
Node Wellcare Mcr Adv $263 - $580 108%
Node Us Dept Of Labor $318 - $702 130%
Ambetter / Centene $359 - $792 147%
Node Health Choice Health Exchange $379 - $837 155%
Node Fusion Network $458 - $1,011 188%
Node J Allen Inmate Health Svcs $484 - $1,067 199%
Self Pay $1,745 - $7,564 716%
Coventry Work Comp Al $5,818 - $11,636 2387%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ 85629
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals