CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Adventist Health Tulare

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $378
  • Cash Discount Price: $448
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Adventist Health Tulare is $378. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $448. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.55x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.
Cash / Self-Pay
$448

Average discount available for prompt cash payment at this facility.

Insurance Median
$378

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: $448 (184%)
Insurance Median: $378 (155%)
Cash: $448 (184% of Medicare)
Ins. Median: $378 (155% 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.

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
Cigna $35 - $4,017 14%
Blue Shield Mcare $64 - $307 26%
Fhcn Pace Mcr Adv - All Plans $64 - $307 26%
Medicare (plans) $64 - $307 26%
Tricare $64 - $307 26%
UnitedHealthcare $64 - $6,284 26%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot $64 26%
Ah Employee Health Plan - All Plans $70 - $552 29%
Incentive Hlth - All Plans $70 - $552 29%
Hs Interplan-All Plans $80 - $5,813 33%
Cal Forensic Med Grp - All Plans $83 - $399 34%
Healthnet Hmo/Ppo - All Other Plans $93 - $818 38%
Blue Cross Blue Shield $103 - $1,660 42%
Blue Shield Epn $117 - $2,125 48%
Blue Shield-All Other Plans $123 - $2,949 50%
Ccipa Medi-Cal - All Plans $126 - $728 52%
Healthnet Medi-Cal $126 - $734 52%
Medi-Cal $126 - $560 52%
Upn-United Physcn Ntwrk Mcal Profee Only $126 - $378 52%
Dignity Mcr Op Only - All Other Plans $307 126%
Prime Health - All Plans $307 126%
Aetna $335 - $2,084 137%
Prison Hlthcre - All Plans $393 161%
Bright Health - All Plans $445 183%
Dignity Mcal Op Only $616 253%
Independence Op Only - All Plans $616 253%
Western Growers - All Plans $1,995 - $3,991 818%
Network By Design-All Plans $3,000 1231%
Multiplan - All Plans $3,687 - $7,375 1512%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 869 North Cherry Street, Tulare, CA 93274
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals