CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Greater El Monte Community Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,018
  • Cash Discount Price: $2,888
  • vs. Medicare Baseline: 4.18x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Greater El Monte Community Hospital is $1,018. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,888. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.18x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$2,888

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,018

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: $2,888 (1185%)
Insurance Median: $1,018 (418%)
Cash: $2,888 (1185% of Medicare)
Ins. Median: $1,018 (418% 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 418% of the Medicare baseline (a markup of 318%). 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
Blue Cross Blue Shield $62 - $1,871 25%
Aids Health Foundation $197 - $302 81%
Altamed Health Network $197 - $302 81%
Avanti $197 - $368 81%
Beverly Hospital $197 - $338 81%
Brand New Day $197 - $384 81%
Emanate Health $197 - $384 81%
Health Net Foundation $197 - $2,300 81%
Healthy Way La $197 81%
La Care Health Plan $197 - $2,058 81%
Other Non Contracted Medi-Cal Hmo $197 81%
State Of California $197 81%
Care 1St Medi Cal Hmo Cap Exceptional Care $200 82%
Veterans Administration $215 88%
Associated Hispanic Physicians $276 - $560 113%
Caloptima $289 119%
Apa/Aco Inc $302 124%
Blue Shield Of California $302 - $4,681 124%
Cms $302 124%
Easy Choice Health Plan $302 124%
Health Net Inc $302 - $2,649 124%
Other Non Contracted Senior Hmo $302 124%
Pacific Alliance Medical Center Reciprocal Contract $302 124%
Scan Health Plan $302 124%
UnitedHealthcare $302 - $3,212 124%
Champus Foundation $307 126%
Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P $307 126%
Good Samaritan Medical Practice Assoc $307 - $2,245 126%
La Care Covered Direct $307 126%
Pacificare Of California $307 126%
Self-Pay $307 126%
Alignment Health Plan $317 130%
Molina Healthcare $317 130%
Inter Valley Health Plan $322 132%
Molina Healthcare Of California $322 - $478 132%
San Miguel Health Plan $338 139%
Central Health Plan $350 - $1,003 144%
Chinatown Service Center Pace $362 149%
Intercomp $367 151%
Knox-Keene Act $384 158%
Preferred Health Network $388 159%
Interplan $396 - $2,806 162%
Universal Care $400 - $1,250 164%
Bella Vista Medical Group Ipa $407 - $1,684 167%
Global Care Medical Group Ipa $407 - $1,684 167%
Athens Administrators $408 167%
Multiplan $408 - $3,180 167%
Other Non Contracted Work Comp $408 167%
Ahmc Healthcare Inc $451 185%
Ahmc Reciprocity Agreement $451 185%
Alta Med Health Services Med Grp $509 - $935 209%
Hollywood Presbyterian Adv Med Mcal $560 230%
Hollywood Presbyterian Medpoint Mcal $560 230%
Cost Containment Strategies $600 246%
Employee Health Systems Medical Group $600 246%
Ahmc Reciprocity Agreement Senior/Commercial $610 - $1,122 250%
California Thoroughbred Horesmans Foundation $1,018 - $1,871 418%
In Custody Police Dept $1,323 - $2,432 543%
Community Care Network $1,628 - $2,993 668%
Health Payors Organization $1,832 - $3,367 752%
Cigna $1,922 788%
Commercial Non Contract $2,035 - $3,741 835%
Medi-Cal Sub Acute $2,035 - $3,741 835%
Nuclear Medicine/Whmc $2,035 - $3,741 835%
One Legacy $2,035 - $3,741 835%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Santa Anita Ave, South El Monte, CA 91733
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals