CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Oak Valley Hospital District

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $723
Cash Discount Price: $990
vs. Medicare Baseline: 2.97x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Oak Valley Hospital District is $723. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $990. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.97x the Medicare baseline. Located in 350 S Oak Ave, Oakdale, CA.

Cash / Self-Pay

$990

Average discount available for prompt cash payment at this facility.

Insurance Median

$723

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: $990 (406%)

Insurance Median: $723 (297%)

Cash: $990 (406% of Medicare)

Ins. Median: $723 (297% 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 297% of the Medicare baseline (a markup of 197%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Alignment Op Only Ip/Op Only-All Plans	$307	126%
Humana	$307	126%
Kaiser Mcr Adv Ip/Op Only	$307	126%
Scan Health Plan Ip/Op Only-All Plans	$313	128%
Imperial Health Ip/Op Only-All Plans	$338	139%
Blue Cross Blue Shield	$560 - $1,426	230%
Healthnet Medi-Cal Ip/Op Only	$560	230%
Kaiser Medi-Cal Ip/Op Only	$560	230%
Medi-Cal Ip/Op Only	$560	230%
Blue Shield Epn Ip/Op Only	$571 - $857	234%
Healthnet Comm Op Only Ip/Op Only-All Other Plans	$612 - $919	251%
Kaiser Comm Ip/Op Only-All Other Plans	$655 - $982	269%
Hp Of San Joaquin Ip/Op Only-All Plans	$672	276%
Blue Shield/Bcout Ip/Op Only-All Other Plans	$697 - $1,045	286%
Cigna	$708 - $1,061	290%
UnitedHealthcare	$739 - $1,109	303%
Aetna	$899 - $1,348	369%

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 $990.
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 Oak Valley Hospital District 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.