CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Atrium Health Navicent the Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $236
Cash Discount Price: $1,791
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Atrium Health Navicent the Medical Center is $236. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,791. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.97x the Medicare baseline. Located in 777 Hemlock Street, Macon, GA.

Cash / Self-Pay

$1,791

Average discount available for prompt cash payment at this facility.

Insurance Median

$236

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: $1,791 (735%)

Insurance Median: $236 (97%)

Cash: $1,791 (735% of Medicare)

Ins. Median: $236 (97% 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.

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
Aetna	$60 - $2,471	25%
Blue Cross Blue Shield	$60 - $236	25%
Georgia Health Advantage	$60 - $236	25%
Humana	$60 - $2,460	25%
UnitedHealthcare	$60 - $2,606	25%
Care Source	$61 - $240	25%
Clover	$61 - $240	25%
Eon Health	$61 - $240	25%
Pruitt Health	$63 - $236	26%
Alliant	$72 - $283	30%
Ambetter / Centene	$81 - $1,826	33%
Cigna	$125 - $866	51%
Kaiser	$167 - $2,328	69%
Securehealth	$245 - $1,253	101%
Multiplan	$2,328 - $2,865	955%
Ibg	$2,532	1039%
Novanet	$2,865	1175%
Three Rivers Provider Network	$3,044	1249%
Beechstreet	$3,330	1366%

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 $1,791.
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 Atrium Health Navicent the Medical Center 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.