CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Ventura County Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $700
  • Cash Discount Price: $3,024
  • vs. Medicare Baseline: 2.87x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Ventura County Medical Center is $700. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,024. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.87x the Medicare baseline. Located in 300 Hillmont Avenue, Ventura, CA.
Cash / Self-Pay
$3,024

Average discount available for prompt cash payment at this facility.

Insurance Median
$700

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: $3,024 (1241%)
Insurance Median: $700 (287%)
Cash: $3,024 (1241% of Medicare)
Ins. Median: $700 (287% 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 287% of the Medicare baseline (a markup of 187%). 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 $298 122%
Alignment Hp - All Plans $307 126%
Blue Shield Mcr Adv $307 126%
Humana $307 126%
UnitedHealthcare $316 - $3,310 130%
Healthnet Mcr Adv $322 132%
Clinicas Mcr Adv $350 144%
Americas Hp Mcr Adv Ip/Op Only $353 145%
Scan-All Plans $368 151%
Western Growers-All Plans $384 158%
Clinicas Comm - All Other Plans $399 164%
Imperial-All Plans $399 164%
Ntwrk Provdrs-All Plans $399 164%
Americas Hp Comm Ip/Op Only-All Other Plans $460 189%
Hpn Ip/Op Only Medi-Cal $560 230%
Kaiser Medi-Cal Ip/Op Only $560 230%
Medi-Cal $560 230%
Kaiser Mcal Pediatric Ip/Op Only $616 253%
Clinicas Mcal $700 287%
Americas Hp Mcal Ip/Op Only $728 299%
Gold Coast Medi-Cal-All Plans $988 405%
Vchcp-All Plans $1,149 471%
Blue Shield Comm - All Other Plans $1,275 523%
Cigna $1,785 732%
Blue Shield Epn $2,346 962%
Healthnet Comm-All Other Plans $3,326 1364%
Kaiser Comm Pediatric Ip/Op Only $3,326 1364%
Aetna $3,507 - $6,047 1439%
Multiplan/Claritev-All Plans $4,838 1985%
Three Rivers Ip/Op Only-All Plans $4,838 1985%
Ppo Next Ip/Op Only-All Plans $5,442 2232%
Blue Cross Blue Shield $5,595 2295%
Kaiser Mcr Pediatric Ip/Op Only $6,047 2481%
Medicare (plans) $6,047 2481%
Hpn Comm Ip/Op Only-All Other Plans $8,587 3523%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Hillmont Avenue, Ventura, CA 93003
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals