CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Good Samaritan Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $14,466
Cash Discount Price: $25,339
vs. Medicare Baseline: 59.34x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Good Samaritan Hospital is $14,466. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25,339. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 59.34x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.

Cash / Self-Pay

$25,339

Average discount available for prompt cash payment at this facility.

Insurance Median

$14,466

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: $25,339 (10395%)

Insurance Median: $14,466 (5934%)

Cash: $25,339 (10395% of Medicare)

Ins. Median: $14,466 (5934% 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 5934% of the Medicare baseline (a markup of 5834%). 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
Santa Clara Family Health Plan	$133	55%
Physicians Medical Group	$206	85%
Blue Cross Blue Shield	$227 - $1,125	93%
United	$518 - $6,916	212%
Medcare Partners	$2,712 - $4,068	1113%
Blue Shield	$4,443	1823%
Aetna	$4,973 - $5,074	2040%
Nx Health Network	$10,850 - $16,274	4451%
Sutter Select	$10,850 - $16,274	4451%
Multiplan	$11,754 - $21,698	4822%
Humana	$12,658 - $18,986	5193%
First Health	$13,743 - $27,123	5638%
Cigna	$14,466 - $21,698	5934%
Healthsmart	$14,466 - $23,054	5934%
Intercontinental Corporation	$14,466 - $21,698	5934%
Pha Pacific Health Alliance	$14,466 - $21,698	5934%
Ppo Next	$14,466 - $21,698	5934%

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 $25,339.
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 Good Samaritan Hospital 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.