CMS Price Transparency Data

MRI, knee or other leg joint

Facility: San Antonio Regional Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $3,230
  • Cash Discount Price: $1,461
  • vs. Medicare Baseline: 13.25x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at San Antonio Regional Hospital is $3,230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,461. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 13.25x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$1,461

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,230

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: $1,461 (599%)
Insurance Median: $3,230 (1325%)
Cash: $1,461 (599% of Medicare)
Ins. Median: $3,230 (1325% 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 1325% of the Medicare baseline (a markup of 1225%). 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 $301 123%
Blue Shield Mcr Adv $307 126%
Caremore Mcr Adv - All Plans $307 126%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $307 126%
Healthnet Mcr Adv $307 126%
Humana $307 126%
Iehp Mcr Adv $307 126%
Inter Valley Hp Mcr Adv- All Plans $307 126%
Kindred Mcr Adv-All Plans $307 126%
Molina Mcr Adv $307 126%
Scan Health Plan Mcr Adv-All Plans $307 126%
Universal Care - All Plans $307 126%
Blue Cross Blue Shield $313 - $7,262 128%
Zelis Mcr Adv $322 132%
Kasiser Mcr Adv $328 135%
Imperial Health Mcr Adv-All Plans $338 139%
Choice Phycn Ntwrk Op Only $384 158%
Molina Exchange-All Other Plans $399 164%
Aetna $414 - $13,361 170%
Iehp Comm - All Other Plans $445 183%
Redlands Employee $460 189%
UnitedHealthcare $462 - $1,579 190%
Redlands Hmo-All Other Plans $479 196%
Prime Health - All Plans $537 220%
Medi-Cal $560 230%
Kaiser Medi-Cal $588 241%
Healthnet Medi-Cal $591 242%
Pc Inland Valley Scan $600 246%
Pc Inland Valley-All Other Plans $600 246%
Alpha Care Mg Mcal/Hlthy Kids $616 253%
Heritage Prov Ntwrk/Regal Mcal $616 253%
Molina Medi-Cal $644 264%
Choicecare Ntwrk-All Plans $700 287%
Iehp Mcal $728 299%
Healthnet - All Other Plans $734 301%
Blue Shield Epn $741 304%
Kaiser Comm - All Other Plans $856 351%
Coventry Ccn/First Hlth - All Plans $1,300 533%
Ambetter / Centene $1,621 - $2,432 665%
Epic Health Plan - All Other Plans $2,672 - $4,008 1096%
Blue Shield Hmo Pos / Calpers Ppo $3,215 - $3,244 1319%
Blue Shield Epo Ppo - All Other Plans $3,244 1331%
Multiplan/Phcs - All Plans $6,413 - $9,620 2631%
Networks By Design - All Plans $6,680 - $8,574 2740%
Zelis Comm-All Other Plans $6,680 - $10,021 2740%
Foundation Inland Epo-All Other Plans $7,126 - $10,689 2923%
Foundation Inland Ppo $7,571 - $11,357 3106%
Health Payors - All Plans $8,016 - $12,025 3288%
Interplan - All Plans $8,016 - $12,025 3288%
Wellcare/Easy Choice-All Plans $8,729 - $13,094 3581%
Alpha Care Mg Mcr Adv $8,907 - $13,361 3654%
Central Hlth Plan Mcr Adv-All Plans $8,907 - $13,361 3654%
Epic Health Plan Mcr Adv $8,907 - $13,361 3654%
Prospect Hp-All Plans $8,907 - $13,361 3654%
Providence Clevercare Mcr Adv $8,907 - $13,361 3654%
Heritage Prov Ntwrk/Regal Mcr Adv $9,041 - $13,561 3709%
Clever Care Mcr Adv - All Plans $9,352 - $14,029 3836%
La Salle Hp Mcr Adv-All Plans $9,352 - $14,029 3836%
Providence Oscar-All Other Plans $9,352 - $14,029 3836%
Alpha Care Mg-All Other Plans $11,134 - $16,701 4567%
Heritage Prov Ntwrk/Regal - All Other Plans $16,367 - $24,551 6714%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals