CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Adventist Health Vallejo

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,731
  • Cash Discount Price: $278
  • vs. Medicare Baseline: 7.10x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Adventist Health Vallejo is $1,731. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $278. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.10x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.
Cash / Self-Pay
$278

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,731

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: $278 (114%)
Insurance Median: $1,731 (710%)
Cash: $278 (114% of Medicare)
Ins. Median: $1,731 (710% 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 710% of the Medicare baseline (a markup of 610%). 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
Cigna $35 - $9,666 14%
Blue Shield Mcr Adv $63 - $242 26%
Medicare (plans) $63 - $242 26%
Napa County Mcal Child $63 - $242 26%
Tricare $63 - $242 26%
Ah Employee Health Plan-All Plans $69 - $435 28%
Interplan-All Plans $76 - $7,250 31%
Kaiser-All Plans $76 - $10,150 31%
Blue Shield Non-Epn-All Other Plans $82 - $5,607 34%
UnitedHealthcare $84 - $7,703 34%
Western Growers-All Plans $93 - $6,404 38%
Phcs-All Plans $116 - $6,646 48%
Health Management Network-All Plans $178 - $10,271 73%
Three Rivers-All Plans $189 - $10,875 78%
Medi-Cal $197 - $560 81%
Aetna $204 - $2,030 84%
Va Mcr-All Other Plans $242 99%
Va Medi-Cal $560 230%
Blue Shield Behav Hlth $595 - $5,437 244%
Blue Shield Epn $623 - $5,691 256%
Choicecare-All Plans $925 - $8,458 379%
Beech Street-All Plans $992 - $9,062 407%
Galaxy Network-All Plans $1,190 - $10,875 488%
Healthnet-All Plans $1,725 708%
Blue Cross Blue Shield $1,737 - $2,084 713%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 Oregon St, Vallejo, CA 94590
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Psychiatric