CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Los Robles Hospital & Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $6,280
Cash Discount Price: $11,192
vs. Medicare Baseline: 25.76x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Los Robles Hospital & Medical Center is $6,280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,192. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 25.76x the Medicare baseline. Located in 215 W Janss Rd, Thousand Oaks, CA.

Cash / Self-Pay

$11,192

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,280

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: $11,192 (4591%)

Insurance Median: $6,280 (2576%)

Cash: $11,192 (4591% of Medicare)

Ins. Median: $6,280 (2576% 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 2576% of the Medicare baseline (a markup of 2476%). 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
Brand New Day	$227	93%
Gold Coast Health Plan	$227	93%
Blue Cross Blue Shield	$315 - $1,115	129%
United	$518 - $4,411	212%
Medcare Partners	$1,090 - $2,354	447%
Aetna	$1,896 - $15,696	778%
First Health	$4,943 - $12,557	2028%
Blue Shield	$5,468 - $7,811	2243%
Multiplan	$5,815 - $14,911	2385%
Ppo Next	$5,815 - $12,557	2385%
Interplan Corporation	$6,542 - $14,126	2684%
Ventura County Foundation	$6,542 - $14,126	2684%

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 $11,192.
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 Los Robles Hospital & Medical Center 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.