CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Sonoma Valley Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $2,445
  • Cash Discount Price: $3,573
  • vs. Medicare Baseline: 10.03x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Sonoma Valley Hospital is $2,445. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,573. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.03x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$3,573

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,445

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: $3,573 (1466%)
Insurance Median: $2,445 (1003%)
Cash: $3,573 (1466% of Medicare)
Ins. Median: $2,445 (1003% 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 1003% of the Medicare baseline (a markup of 903%). 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
Tricare $322 132%
Blue Cross Blue Shield $328 - $3,349 135%
Bright Hlth/Brand New Day Mcr Adv $328 135%
Hospice Of Marin-All Plans $328 135%
St Joseph Heritage Hltcare Comm-All Other Plans $328 135%
Veterans Admin-All Plans $328 135%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $345 142%
Cdcr Prison-All Plans $394 162%
Three Rivers (Trpn)-All Plans $394 162%
Aetna $419 172%
First Health(Coventry)-All Plans $419 172%
Chp - Correctional Health Partners - All Plans $427 175%
Bright Hlth/Brand New Day - All Other Plands $443 182%
Wellpath - All Plans $459 188%
Medi-Cal $560 230%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $591 242%
Canopy Health Solutions-All Other Plans $591 242%
UnitedHealthcare $893 366%
Mcal Mgd Care (Php)-All Plans $924 379%
Comm Care Network(Ccn)-All Plans $1,000 410%
Partnership Healthplan-All Plans $1,960 804%
Healthnet Hmo/Ppo-All Other Plans $1,991 817%
Blue Shield Ppo-All Plans $2,899 1189%
Kaiser-All Plans $3,318 1361%
Integrated Health Plan-All Plans $3,777 1549%
Champus-All Plans $4,083 1675%
Cigna $4,083 1675%
Networks By Design - All Plans $4,083 1675%
Great West-One Health Plan Ppo/Pos-All Plans $4,338 1780%
Phcs/Multiplan/Beech St-All Plans $4,338 1780%
Interplan-All Plans $4,492 1843%
Bps-All Plans $4,594 1885%
Ppo Alliance-All Plans $4,594 1885%
Pref Health Networl(Phn)-All Plans $4,594 1885%
Meritage Medical Network Op Only Mcare $5,104 2094%
Scan Mcare-All Plans $5,104 2094%
St Joseph Heritage Hltcare Mcr Adv $5,104 2094%
Correct Care Integ Health-All Plans $6,125 2513%
Employer Direct Healthcare-All Plans $6,125 2513%
Meritage Medical Network Op Only-All Other Plans $6,431 2638%
Creative Legal Services-All Plans $6,635 2722%
Canopy Op Only $9,187 3769%
Vnpn - All Plans $9,187 3769%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals