CMS Price Transparency Data

MRI, knee or other leg joint

Facility: St Marys Good Samaritan Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $953
Cash Discount Price: $1,911
vs. Medicare Baseline: 3.91x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at St Marys Good Samaritan Hospital is $953. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,911. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.91x the Medicare baseline. Located in 5401 Lake Oconee Parkway, Greensboro, GA.

Cash / Self-Pay

$1,911

Average discount available for prompt cash payment at this facility.

Insurance Median

$953

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: $1,911 (784%)

Insurance Median: $953 (391%)

Cash: $1,911 (784% of Medicare)

Ins. Median: $953 (391% 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 391% of the Medicare baseline (a markup of 291%). 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
Amerigroup	$360	148%
Blue Cross Blue Shield	$455 - $2,550	187%
Peach State	$456	187%
Wellcare	$456 - $953	187%
Aetna	$635 - $2,823	260%
Ambetter / Centene	$635 - $953	260%
Care Improvement Plus	$635 - $953	260%
Caresource	$635 - $953	260%
Cigna	$635 - $2,894	260%
Coventry	$635 - $2,647	260%
Eon Health Plan	$635 - $953	260%
Humana	$635 - $2,647	260%
Kaiser Permanente	$635 - $953	260%
Molina	$635 - $953	260%
Pruitthealth Premier	$635 - $953	260%
Todays Options Pffs	$635 - $953	260%
Todays Options Ppo	$635 - $953	260%
UnitedHealthcare	$635 - $2,632	260%
Vaccn United	$635 - $953	260%
First Health	$1,764 - $2,647	724%
Phcs	$1,764 - $2,647	724%
Meritain	$1,882 - $2,823	772%
Multiplan	$1,999 - $3,070	820%
Nova	$1,999 - $3,176	820%
Three Rivers Provider Network	$2,117 - $3,176	868%

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 $1,911.
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 St Marys Good Samaritan 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.