CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Valley Children's Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $3,442
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 14.12x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Valley Children's Hospital is $3,442. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.12x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,442

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%)
Insurance Median: $3,442 (1412%)
Ins. Median: $3,442 (1412% 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 1412% of the Medicare baseline (a markup of 1312%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Allcare Ipa $560 - $3,442 230%
Kaiser $566 - $4,475 232%
Dignity Ipa_Formerly Img $784 322%
La Salle Ipa $784 322%
Sante Ipa $784 322%
Central Valley Medical Providers Ipa $840 - $3,442 345%
Sequoia Health Ipa $840 345%
Univseral Healthcare Ipa $840 345%
United Physicians Network Ipa $868 - $3,442 356%
Community Care Ipa $885 363%
Adventist $988 405%
Blue Cross Blue Shield $1,015 - $5,405 416%
Cencal Health $1,107 454%
Kern Family Health Care $1,119 459%
Central California Alliance For Health $1,139 467%
UnitedHealthcare $1,549 635%
Health Net $2,422 - $4,508 994%
Dignity Health Central Coast $3,411 1399%
Community Health $3,786 1553%
Stanislaus Partners In Health $3,786 1553%
Physicians Choice Medical Group $3,855 1581%
Health Plan Of San Joaquin $4,130 1694%
Fowler Packing $4,268 1751%
Dignity (Formerly Managed Care Systems) $4,337 1779%
Kern Legacy $4,475 1836%
Blue Shield $4,598 - $5,223 1886%
Aetna $4,612 1892%
First Health Formerly Coventry $5,094 2090%
Bakersfield Family Medical Group $5,163 2118%
Network By Design $5,335 2189%
Community Care Health Plan $5,505 2258%
Health Smart $5,507 2259%
Key Medical Ipa $5,507 2259%
Sutter Health $5,851 2400%
Multiplan $6,586 2702%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens