CMS Price Transparency Data

MRI, knee or other leg joint

Facility: St Francis Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $928
  • Cash Discount Price: $2,259
  • vs. Medicare Baseline: 3.81x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at St Francis Hospital is $928. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,259. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.81x the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.
Cash / Self-Pay
$2,259

Average discount available for prompt cash payment at this facility.

Insurance Median
$928

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: $2,259 (927%)
Insurance Median: $928 (381%)
Cash: $2,259 (927% of Medicare)
Ins. Median: $928 (381% 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 381% of the Medicare baseline (a markup of 281%). 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
Pace-Trinity Health $249 102%
Saint Francis Life $249 102%
Blue Cross Blue Shield $254 - $2,038 104%
Cigna $256 - $3,227 105%
Medicare (plans) $260 - $266 107%
Blue Shield - De (Highmark) Medciare Advantage $262 107%
Highmark Health Options Dual Plan $262 107%
Aetna $269 - $1,951 110%
Coventry $305 125%
Delaware First Health $429 176%
Blue Benefit Administrators Of Massachusetts $928 381%
Blue Care Network $928 381%
Blue Distinction Transplant $928 381%
Blue Shield - Ca $928 381%
Blue Shield - Id (Regence) $928 381%
Blue Shield - Ny Highmark Northeastern $928 381%
Blue Shield - Ny Highmark Western $928 381%
Blue Shield - Pa (Highmark) $928 381%
Blue Shield - Wa (Regence) $928 381%
Medicaid / KanCare $1,216 - $1,825 499%
Meritain $1,951 800%
Trustmark Small Business Benefits $1,951 800%
Devon Health Services $3,301 - $4,952 1354%
Galaxy Health Network $3,301 - $4,952 1354%
Multiplan $3,301 - $4,952 1354%
Prime Health Services $3,301 - $4,952 1354%
Three Rivers Provider Network $3,301 - $4,952 1354%
Wc Corvel $3,301 - $4,952 1354%
Geha $3,336 - $5,004 1369%
UnitedHealthcare $3,336 - $5,004 1369%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7Th and Clayton Sts, Wilmington, DE 19805
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals