CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Menifee Global Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $723
  • Cash Discount Price: $3,471
  • vs. Medicare Baseline: 2.97x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Menifee Global Medical Center is $723. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,471. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.97x the Medicare baseline. Located in 28400 McCall Boulevard, Sun City, CA.
Cash / Self-Pay
$3,471

Average discount available for prompt cash payment at this facility.

Insurance Median
$723

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: $3,471 (1424%)
Insurance Median: $723 (297%)
Cash: $3,471 (1424% of Medicare)
Ins. Median: $723 (297% 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 297% of the Medicare baseline (a markup of 197%). 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 $187 - $285 77%
Lasalle Medical Assoc (Ancillary) Mcal Hmo $232 95%
Cigna $302 - $3,453 124%
Aetna $305 - $2,358 125%
Altamed Comm Hmo (Ancillary) $305 - $4,316 125%
Altamed Health Services Senior $305 125%
Altamed Sr/Pace $305 125%
Blue Shield Senior $305 125%
Central Health Plan Senior $305 125%
Clever Care Health Plan Sr $305 125%
For Your Benefit Senior $305 125%
Guidant Health Plan Senior $305 125%
Health Net Senior $305 125%
Hpn Senior $305 125%
Humana $305 125%
Ic $305 - $4,316 125%
Kaiser Senior $305 125%
Lasalle Medical Assoc (Ancillary) Senior $305 125%
Managed Health Network Sr $305 125%
Medicare (plans) $305 125%
Neighborhood Healthcare Pace $305 125%
Primecare Senior $305 125%
Prospect Health Plan Sr Hmo $305 125%
Scan Senior $305 125%
Sr Capitation $305 125%
UnitedHealthcare $305 - $368 125%
Veterans Administration $305 125%
Imperial Health Plan Of Ca $307 126%
Lasalle Medical Assoc (Ancillary) Commercial $307 126%
Point Comfort Underwriters $307 126%
Self Pay/Ab774/Charity Discount $307 126%
Health Net Enhanced Ppo $308 - $428 126%
Molina Covered Ca $335 137%
Align Senior Care $342 140%
Welbehealth Sr/Pace $342 140%
Prime Health Services Senior $351 144%
Coventry $367 - $382 151%
Prime Health Services Wcomp $367 151%
Iehp Covered Ca $382 157%
Three Rivers Wcomp $400 164%
Workers Comp Non-Contracted $408 167%
Prospect Health Plan Comm Hmo $412 169%
Hpn Commercial/Covered Ca $428 176%
Health Net Comm $458 188%
Three Rivers Network $537 220%
Velocity $537 - $1,942 220%
Health Net Medi-Cal $560 230%
Hpn Mcal $560 230%
Kaiser Medi-Cal $560 230%
Prospect Health Plan Mcal Hmo $577 237%
Blue Cross Blue Shield $588 241%
Molina Medi-Cal $661 271%
Altamed Mcal Hmo $784 322%
Altamed Mcal/Pace $784 322%
Choice Physicians Network $784 322%
Iehp Medi-Cal $840 345%
Primecare Commercial $845 347%
Blue Shield Epn $858 352%
Blue Shield Commercial $1,011 415%
First Health Commercial $1,378 - $2,266 565%
Multiplan Ppo $1,838 - $3,021 754%
Multiplan Wcomp $1,838 - $3,021 754%
Pnoa-Provider Network Of America $2,100 - $3,453 861%
Prime Health Services Commercial $2,100 - $3,453 861%
Ava Hospice $2,625 - $4,316 1077%
Kaiser Commercial $2,625 - $4,316 1077%
Living Waters Hospice $2,625 - $4,316 1077%
Managed Health Network $2,625 - $4,316 1077%
Other Insurance Loa $2,625 - $4,316 1077%
Pacific Valley Hospice $2,625 - $4,316 1077%
Private Pay $2,625 - $4,316 1077%
Silverado Hospice $2,625 - $4,316 1077%
Vna Hospice $2,625 - $4,316 1077%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 28400 McCall Boulevard, Sun City, CA 92585
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals