CMS Price Transparency Data
MRI, knee or other leg joint
Facility: Coastal Communities Hospital
Billing Code: 73721 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73721
- Insurance Median: $731
- Cash Discount Price: $5,862
- vs. Medicare Baseline: 3.00x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Coastal Communities Hospital is $731. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,862. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.00x the Medicare baseline. Located in 2701 S Bristol St, Santa Ana, CA.
Cash / Self-Pay
$5,862
Average discount available for prompt cash payment at this facility.
Insurance Median
$731
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: $5,862 (2405%)
Insurance Median: $731 (300%)
Cash: $5,862 (2405% of Medicare)
Ins. Median: $731 (300% 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 300% of the Medicare baseline (a markup of 200%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Kpc Healthcare Inc | $236 - $846 | 97% |
| Monarch | $249 - $674 | 102% |
| Ihhi Reciprocity | $270 | 111% |
| Altamed Health Services | $290 - $784 | 119% |
| Champus | $295 - $650 | 121% |
| Blue Shield | $305 - $2,567 | 125% |
| Central Health Plan Of California | $305 - $674 | 125% |
| Champion Health Plan | $305 - $674 | 125% |
| Citizens Choice Health Plan | $305 - $674 | 125% |
| Clever Care Health Plan | $305 - $674 | 125% |
| Easy Choice Health Plan | $305 - $674 | 125% |
| For Your Benefit | $305 - $674 | 125% |
| Health Net | $305 - $4,649 | 125% |
| Healthcare Partners Sr Hmo | $305 - $674 | 125% |
| Heritage | $305 - $674 | 125% |
| Hollywood Presbyterian | $305 - $674 | 125% |
| Humana | $305 - $674 | 125% |
| Kaiser | $305 - $4,332 | 125% |
| Onecare | $305 - $674 | 125% |
| Onecare Connect | $305 - $674 | 125% |
| Other Senior Non Contract | $305 - $674 | 125% |
| Prospect Health Plan | $305 - $1,016 | 125% |
| Scan Health Plan | $305 - $674 | 125% |
| UnitedHealthcare | $305 - $674 | 125% |
| Us Federal Marshall/Department Of Immigration | $305 - $674 | 125% |
| Velocity Provider Network Sr | $305 - $674 | 125% |
| Verda Health Plan Sr | $305 - $674 | 125% |
| Veterans Administration | $305 - $674 | 125% |
| Caloptima | $307 - $784 | 126% |
| Choice Physicians Network | $307 - $677 | 126% |
| Imperial Health Plan Of Ca | $307 - $677 | 126% |
| Innovative Integrated Health | $307 - $677 | 126% |
| Medcare Partners | $307 - $677 | 126% |
| Self Pay Ab774/Cbo Use Only | $307 - $677 | 126% |
| Us Dept Of Labor | $307 - $677 | 126% |
| Victim Of Violent Crime | $307 - $677 | 126% |
| Victoria Hospice | $307 - $677 | 126% |
| Cigna | $309 - $4,572 | 127% |
| Monarch Health Plan | $314 | 129% |
| Brand New Day | $342 - $755 | 140% |
| Prime Health Srvs | $351 - $5,627 | 144% |
| Coventry Auto Network | $367 - $810 | 151% |
| Prime Health Srvs/Wc | $367 - $810 | 151% |
| Interplan | $371 - $5,276 | 152% |
| County Of Orange/Custody/Advanced Medmgt | $382 - $842 | 157% |
| Coventry Wc | $382 - $842 | 157% |
| Veterans Evaluation Services | $384 - $846 | 158% |
| Multiplan | $400 - $4,924 | 164% |
| Three Rivers | $400 - $883 | 164% |
| Velocity National Provider Network Wc | $408 - $901 | 167% |
| Workers Comp State Of California | $408 - $901 | 167% |
| Staywell/Island Home Ins | $430 - $948 | 176% |
| Three Rivers Network | $537 - $1,185 | 220% |
| Velocity National Provider Network Ppo | $537 - $1,185 | 220% |
| Altamed Mcal Hmo (Ancillary) | $560 | 230% |
| Healthcare Partners | $560 | 230% |
| Medi-Cal Hmo/Non Contract | $560 | 230% |
| Medicaid / KanCare | $560 | 230% |
| Choc Health Alliance | $784 | 322% |
| County Of Orange | $784 | 322% |
| Family Choice | $784 | 322% |
| Heritage Provider Network | $784 - $3,004 | 322% |
| Aetna | $917 | 376% |
| First Health | $2,462 - $3,693 | 1010% |
| Magellan | $2,814 - $4,220 | 1154% |
| Networks By Design | $3,283 - $4,924 | 1347% |
| Networks By Design Wc | $3,283 - $4,924 | 1347% |
| Healthsmart | $3,518 - $5,276 | 1443% |
| Prime Health | $3,518 - $5,276 | 1443% |
| Pnoa-Provider Network Of America | $3,752 - $5,627 | 1539% |
| Prime Health Srvs/Network | $3,986 - $5,979 | 1635% |
| Lucet Behavioral Health Sr | $4,690 - $7,034 | 1924% |
| Managed Health Network | $4,690 - $7,034 | 1924% |
| Other Insurance Loa | $4,690 - $7,034 | 1924% |
| Other Non Contracted Plans | $4,690 - $7,034 | 1924% |
| Private Pay | $4,690 - $7,034 | 1924% |
| Us Behavioral Health Plan | $4,690 - $7,034 | 1924% |
| Vitas Hospice | $4,690 - $7,034 | 1924% |