CMS Price Transparency Data

MRI, knee or other leg joint

Facility: St Rose Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $429
Cash Discount Price: $899
vs. Medicare Baseline: 1.76x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at St Rose Hospital is $429. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $899. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.76x the Medicare baseline. Located in 27200 Calaroga Ave, Hayward, CA.

Cash / Self-Pay

$899

Average discount available for prompt cash payment at this facility.

Insurance Median

$429

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: $899 (369%)

Insurance Median: $429 (176%)

Cash: $899 (369% of Medicare)

Ins. Median: $429 (176% 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.

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Cigna	$221 - $2,248	91%
Healthnet Of California	$221 - $2,098	91%
UnitedHealthcare	$221 - $1,900	91%
Centers For Elder Independence	$322	132%
Aetna	$339 - $1,600	139%
Brown & Toland	$339	139%
Humana	$339	139%
Imperial Health Senior	$339	139%
Medicare (plans)	$339	139%
Canopy	$645	265%
Blue Shield	$848	348%
Blue Shield Affinity	$848	348%
Blue Shield Hill	$848	348%
Blue Cross Blue Shield	$895	367%
Interplan	$2,098	861%
Multiplan Inc	$2,307	946%
Kaiser Foundation Hospitals	$2,397	983%
Preferred Health Network	$2,547	1045%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $899.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73721.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Rose Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73721.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.