CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Seneca District Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $3,348
Cash Discount Price: $2,819
vs. Medicare Baseline: 13.73x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Seneca District Hospital is $3,348. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,819. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 13.73x the Medicare baseline. Located in 130 Brentwood Drive, Chester, CA.

Cash / Self-Pay

$2,819

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,348

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: $2,819 (1156%)

Insurance Median: $3,348 (1373%)

Cash: $2,819 (1156% of Medicare)

Ins. Median: $3,348 (1373% 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 1373% of the Medicare baseline (a markup of 1273%). 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
Medi-Cal	$560	230%
Amthem Bc Mcal	$569	233%
Ambetter / Centene	$683	280%
UnitedHealthcare	$1,339 - $3,454	549%
Partnership Hp-All Plans	$1,960	804%
Tricare	$2,467	1012%
Imperial Hp Ma-All Plans	$2,787	1143%
Blue Cross Blue Shield	$2,886 - $3,172	1184%
Blue Shield Ipf/Ca Exchange	$3,140	1288%
Beech Street Corp- All Plans	$3,348	1373%
Cigna	$3,348	1373%
Integrated Hp-All Plans	$3,348	1373%
Interplan Corp- All Plans	$3,348	1373%
Medincrease- All Plans	$3,348	1373%
Multiplan- All Plans	$3,348	1373%
Pacificare - All Plans	$3,348	1373%
Provider Ntwrk Of America-All Plans	$3,348	1373%
Alliance- All Plans	$3,418	1402%
Community Care Network - All Plans	$3,418	1402%
Coventry- All Plans	$3,454	1417%
Northern Nevada Health Network- All Plans	$3,454	1417%
Superior California Ppo - All Plans	$3,454	1417%
Blue Shield Of Ca- All Other Plans	$3,489	1431%
Healthnet - All Other Plans	$3,489	1431%
Three Rivers- All Plans	$3,489	1431%

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 $2,819.
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 Seneca District 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.