CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Loma Linda University Children's Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $962
Cash Discount Price: $1,901
vs. Medicare Baseline: 3.95x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Loma Linda University Children's Hospital is $962. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,901. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.95x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$1,901

Average discount available for prompt cash payment at this facility.

Insurance Median

$962

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: $1,901 (780%)

Insurance Median: $962 (395%)

Cash: $1,901 (780% of Medicare)

Ins. Median: $962 (395% 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 395% of the Medicare baseline (a markup of 295%). 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
Alpha Care Medical Group	$307 - $461	126%
Dignity Health	$307 - $461	126%
Epic Health Plan	$307 - $1,924	126%
Inland Empire Health Plan (Iehp)	$307 - $656	126%
Kaiser Foundation Hospitals	$307 - $3,208	126%
Upland Medical Group	$307	126%
Vantage Medical Group	$307 - $461	126%
Molina Healthcare Of Ca	$387 - $412	159%
Heritage Provider Network	$504	207%
Adventist Health	$728 - $962	299%
UnitedHealthcare	$866	355%
Lluh Dept Of Risk Management	$874 - $1,154	359%
Blue Shield Of California	$1,471 - $2,228	603%
Global Benefits Group	$2,185 - $2,885	896%
Temecula Valley Physicians Medical Group	$2,185	896%
Trivalley Medical Group	$2,185	896%
Blue Cross Blue Shield	$2,236	917%
Cigna	$2,330 - $2,694	956%
Networks By Design	$2,367 - $3,126	971%
Multiplan	$2,913 - $3,847	1195%
Galaxy Health	$3,095 - $4,088	1270%
Prime Health Services	$3,095 - $4,088	1270%
Aetna	$3,443	1412%

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 $1,901.
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 Loma Linda University Children's Hospital 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.