CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Doctors Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,051
Cash Discount Price: $8,296
vs. Medicare Baseline: 4.31x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Doctors Hospital is $1,051. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,296. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.31x the Medicare baseline. Located in 3651 Wheeler Road, Augusta, GA.

Cash / Self-Pay

$8,296

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,051

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: $8,296 (3403%)

Insurance Median: $1,051 (431%)

Cash: $8,296 (3403% of Medicare)

Ins. Median: $1,051 (431% 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 431% of the Medicare baseline (a markup of 331%). 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
Blue Cross Blue Shield	$92 - $408	38%
Health One Alliance	$233	96%
Ambetter / Centene	$324	133%
Aetna	$355 - $6,098	146%
United	$518 - $4,977	212%
Prime Health	$608	249%
Rockport United Network	$621	255%
Identity Mco	$633	260%
Blue Choice	$726	298%
Amerigroup	$785 - $1,571	322%
Absolute Total Care	$996 - $1,991	409%
Nhc Advantage	$1,051 - $2,102	431%
Pruitt Health	$1,051 - $2,102	431%
Peach State	$1,106 - $2,212	454%
Wellcare	$1,106 - $2,212	454%
Americas 1St Choice	$1,549 - $3,097	635%
Medcost	$2,771 - $7,068	1137%
Multiplan	$3,319 - $9,955	1362%
Performax	$3,761 - $7,522	1543%
First Health	$4,149 - $8,296	1702%
Employer'S Health Network	$4,425 - $8,849	1815%
Novanet	$4,978 - $9,955	2042%

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 $8,296.
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 Doctors 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.