CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Adventist Health and Rideout

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $4,311
Cash Discount Price: $1,365
vs. Medicare Baseline: 17.68x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Adventist Health and Rideout is $4,311. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,365. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 17.68x the Medicare baseline. Located in 726 4Th St, Marysville, CA.

Cash / Self-Pay

$1,365

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,311

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: $1,365 (560%)

Insurance Median: $4,311 (1768%)

Cash: $1,365 (560% of Medicare)

Ins. Median: $4,311 (1768% 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 1768% of the Medicare baseline (a markup of 1668%). 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
Bc Mcal	$181	74%
Kaiser Mcr Adv	$308	126%
Tricare	$308	126%
UnitedHealthcare	$308 - $6,467	126%
Blue Cross Blue Shield	$311 - $1,657	128%
Ah Employee Health Plan - All Plans	$554	227%
Kaiser Mcal	$560	230%
Medi-Cal	$560	230%
Ca Health And Wellness- All Plans	$695	285%
Celtic Mcaid-All Plans	$695	285%
Healthnet Mcal	$993 - $1,474	407%
Healthnet Comm-All Other Plans	$3,191 - $4,787	1309%
Aetna	$3,509 - $5,264	1439%
Kaiser-All Other Plans	$3,772 - $5,658	1547%
Blue Shield Uc Care Members	$3,970 - $5,956	1629%
Cigna	$4,230 - $6,345	1735%
First Health-All Plans	$4,343 - $6,514	1782%
Phcs-All Plans	$4,367 - $6,552	1791%
Interplan-All Plans	$4,467 - $6,700	1832%
Blue Shield-All Other Plans	$4,715 - $7,073	1934%
Multiplan-All Plans	$4,715 - $7,073	1934%
Partnership Hp Mcal -All Plans	$8,189 - $12,284	3359%

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 $1,365.
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 Adventist Health and Rideout 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.