CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Casa Colina Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $560
  • Cash Discount Price: $399
  • vs. Medicare Baseline: 2.30x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Casa Colina Hospital is $560. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $399. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.30x the Medicare baseline. Located in 255 E Bonita Ave, Pomona, CA.
Cash / Self-Pay
$399

Average discount available for prompt cash payment at this facility.

Insurance Median
$560

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: $399 (164%)
Insurance Median: $560 (230%)
Cash: $399 (164% of Medicare)
Ins. Median: $560 (230% 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 230% of the Medicare baseline (a markup of 130%). 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
Heritage Prvdr Ntwrk Mcal $246 101%
Prospect Hp Mcal $276 113%
Heritage Prvdr Ntwrk Comm - All Other Plans $280 - $605 115%
Heritage Prvdr Ntwrk Mcr $280 - $605 115%
Healthnet Comm - All Other Plans $287 - $620 118%
Promed Hlth Ntwrk Op Only - All Plans $292 120%
Aetna $307 - $756 126%
Blue Cross Blue Shield $307 - $886 126%
Blue Shield Mcr Adv $307 126%
Caremore Mcr Adv - All Plans $307 126%
Central Hlth Plan - All Plans $307 126%
Doctors Managed Op Only - All Plans $307 126%
Empire Healthcare Op Only - All Plans $307 126%
Epic Comm - All Other Plans $307 126%
Epic Mcr Adv $307 126%
Focus Healthcare Wc - All Plans $307 126%
Healthnet Mcr Adv $307 126%
Humana $307 - $756 126%
Iehp - All Other Plans $307 126%
Iehp Mcr Adv $307 126%
Kaiser Comm - All Other Plans $307 126%
Kaiser Mcr Adv $307 126%
Premiercare Op Only - All Plans $307 126%
Prospect Hp Mcr Adv $307 126%
Triwest - All Plans $307 126%
UnitedHealthcare $307 - $756 126%
Wellcare Mcr Adv - All Plans $307 126%
Prospect Hp Comm - All Other Plans $338 139%
Corvel - All Plans $350 - $756 144%
Coventry - All Plans $350 - $756 144%
Multiplan - All Plans $350 - $756 144%
Three Rivers - All Plans $350 - $756 144%
Affiliated Hlth Funds - All Plans $384 158%
Cigna $392 - $845 161%
Brand New Day Mcr Adv - All Plans $420 - $907 172%
Galaxy Provdr Ntwrk - All Plans $490 - $1,058 201%
Blue Shield Comm - All Other Plans $518 - $1,117 212%
Healthcare Partners - All Other Plans $560 - $1,210 230%
Healthcare Partners Mcr $560 - $1,210 230%
Medi-Cal $560 230%
Primecare Comm - All Other Plans $560 - $1,210 230%
Primecare Mcr Adv $560 - $1,210 230%
Prospect Med Grp Alta - All Plans $595 - $1,285 244%
Kaiser Mcal $616 253%
Iehp Mcal $701 - $1,400 288%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 E Bonita Ave, Pomona, CA 91767
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals