CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Grossmont Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $2,165
  • Cash Discount Price: $3,247
  • vs. Medicare Baseline: 8.88x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Grossmont Hospital is $2,165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,247. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.88x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.
Cash / Self-Pay
$3,247

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,165

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: $3,247 (1332%)
Insurance Median: $2,165 (888%)
Cash: $3,247 (1332% of Medicare)
Ins. Median: $2,165 (888% 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 888% of the Medicare baseline (a markup of 788%). 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
Blue Cross Blue Shield $120 - $2,900 49%
Medicare (plans) $1,212 497%
Community Health Group $1,286 - $2,164 528%
Molina $1,286 - $3,030 528%
Blue Shield $1,472 - $2,641 604%
Health Net $1,472 - $3,463 604%
Interplan $1,472 604%
Kaiser $1,472 604%
Aetna $1,818 - $3,550 746%
UnitedHealthcare $1,818 - $2,987 746%
Medi-Cal $2,003 822%
San Diego Pace $2,078 852%
Indian Health Council $2,164 888%
County Medical Services $2,749 1128%
Managed Health Network $2,900 1190%
Cigna $3,247 1332%
Epic Americas $3,247 1332%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5555 Grossmont Center Drive Box 58, La Mesa, CA 91942
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals