CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mayers Memorial Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $697
Cash Discount Price: $628
vs. Medicare Baseline: 2.86x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mayers Memorial Hospital is $697. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $628. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.86x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.

Cash / Self-Pay

$628

Average discount available for prompt cash payment at this facility.

Insurance Median

$697

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: $628 (258%)

Insurance Median: $697 (286%)

Cash: $628 (258% of Medicare)

Ins. Median: $697 (286% 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 286% of the Medicare baseline (a markup of 186%). 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
Blue Shield Ca Va	$61 - $656	25%
Blue Shield Mcr Adv	$61 - $656	25%
Tricare	$61 - $690	25%
Health Net Mcr Adv	$64 - $690	26%
Arcadian Health Services-All Plans	$67 - $690	27%
Imperial Health Plan-All Plans	$72 - $780	30%
Medi-Cal	$197 - $560	81%
Cigna	$200 - $993	82%
Corvel Ppo-All Plans	$200 - $993	82%
Coventry/First Health-All Plans	$200 - $993	82%
Integrated Hp-All Plans	$200 - $993	82%
Interplan-All Plans	$200 - $993	82%
Blue Cross Blue Shield	$697 - $894	286%
Health Net Prison	$752	308%
Blue Shield Ca Exchange	$894	367%
Blue Shield-All Other Plans	$993	407%
Hmn-All Plans	$993	407%
Multiplan Phcs-All Plans	$993	407%
Pfmc-All Plans	$993	407%
Superior Ca-All Plans	$993	407%
Health Net-All Other Plans	$1,040	427%
Pacificare-All Plans	$1,046	429%
Partnership Hp-All Plans	$1,046	429%

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 $628.
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 Mayers Memorial 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.