CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Piedmont Fayette Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,754
Cash Discount Price: $1,516
vs. Medicare Baseline: 7.20x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Piedmont Fayette Hospital is $1,754. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,516. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.20x the Medicare baseline. Located in 1255 Highway 54 West, Fayetteville, GA.

Cash / Self-Pay

$1,516

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,754

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: $1,516 (622%)

Insurance Median: $1,754 (720%)

Cash: $1,516 (622% of Medicare)

Ins. Median: $1,754 (720% 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 720% of the Medicare baseline (a markup of 620%). 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
Medicaid / KanCare	$465 - $489	191%
UnitedHealthcare	$584	240%
Cigna	$683 - $955	280%
Alliant Health Plans Of Georgia [10952]	$1,248	512%
Aetna	$2,260	927%
First Health [10303]	$3,537	1451%
Phcs [10601]	$3,537	1451%
Kaiser [10500]	$3,739	1534%
Novanet [10819]	$3,789	1554%
Beechstreet [10800]	$4,042	1658%
Multiplan [10600]	$4,294	1761%

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 $1,516.
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 Piedmont Fayette 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.