CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Adventist Health Delano

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,457
Cash Discount Price: $594
vs. Medicare Baseline: 5.98x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Adventist Health Delano is $1,457. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $594. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.98x the Medicare baseline. Located in 1401 Garces Highway, Delano, CA.

Cash / Self-Pay

$594

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,457

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: $594 (244%)

Insurance Median: $1,457 (598%)

Cash: $594 (244% of Medicare)

Ins. Median: $1,457 (598% 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 598% of the Medicare baseline (a markup of 498%). 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
Blue Cross Blue Shield	$196 - $2,966	80%
Bakersfield Fam Med Grp-All Plans	$307	126%
Healthnet Mcr Adv	$307	126%
Kern Mcr Adv Dual Dnsp-All Other Plans	$307	126%
Medicare (plans)	$307 - $491	126%
Tricare	$307	126%
UnitedHealthcare	$307 - $2,565	126%
Universal Care Mcr- All Other Plans	$307	126%
Dignty Hlth Com/Mcr Op Only - All Other Plans	$350	144%
Dignty Hlth Mcal Op Only	$350	144%
Blue Shield Epn - All Other Plans	$520 - $781	213%
Kaiser Comm Ip/Op Only- All Other Plans	$528	217%
Ah Employee Health Plan - All Plans	$552	226%
Kaiser Medi-Cal Ip/Op Only	$560	230%
Medi-Cal	$560	230%
Universal Care Mcal	$560	230%
Healthnet Medi-Cal	$667	274%
Centivo - All Plans	$690	283%
Kern Health System Mcal	$723	297%
Healthnet- All Other Plans	$1,307 - $1,489	536%
Coventry- All Plans	$1,426 - $2,138	585%
Blue Shield Non-Epn	$1,544 - $2,317	633%
Aetna	$1,649	676%
County Of Kern Network - All Plans	$1,663 - $2,495	682%
Gem Care- All Plans	$1,663 - $2,495	682%
Foundation For Medical Care Of Kern County - All P	$1,782 - $2,673	731%
Cigna	$1,901 - $2,851	780%
Western Growers - All Plans	$1,925 - $2,887	790%

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 $594.
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 Delano 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.