CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Children's Healthcare of Atlanta at Scottish Rite

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $3,557
Cash Discount Price: $6,181
vs. Medicare Baseline: 14.59x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Children's Healthcare of Atlanta at Scottish Rite is $3,557. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,181. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.59x the Medicare baseline. Located in 1001 Johnson Ferry Road, Atlanta, GA.

Cash / Self-Pay

$6,181

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,557

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: $6,181 (2536%)

Insurance Median: $3,557 (1459%)

Cash: $6,181 (2536% of Medicare)

Ins. Median: $3,557 (1459% 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 1459% of the Medicare baseline (a markup of 1359%). 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
Peachstate [43]	$1,723 - $3,445	707%
Caresource [61]	$1,770 - $3,539	726%
Amerigroup [102]	$1,788 - $3,575	733%
Cigna	$2,724 - $5,447	1117%
Blue Cross Blue Shield	$2,734 - $8,045	1122%
United [5]	$2,734 - $5,468	1122%
Ambetter / Centene	$2,759 - $5,517	1132%
Oscar [228]	$2,761 - $5,521	1133%
Aetna	$2,773 - $5,546	1138%
Caresource Marketplace Bronze/Silver/Gold [60]	$2,800 - $5,600	1149%
Kaiser [6]	$2,806 - $5,611	1151%
Sidecar Health [236]	$2,843 - $5,686	1166%
Direct Employer Agreements [72]	$2,885 - $7,005	1183%
Coventry [9]	$2,892 - $5,784	1186%
Northeast Georgia Heatlh System [808]	$3,091 - $6,181	1268%
Veracity Benefits [809]	$3,091 - $6,181	1268%
First Health [74]	$3,093 - $6,186	1269%
Phcs [93]	$3,503 - $7,005	1437%
Secure Health [340]	$3,503 - $7,005	1437%
Beech Street [71]	$3,709 - $7,417	1522%
Multiplan [92]	$4,039 - $8,076	1657%
Novanet [41]	$4,121 - $8,241	1691%

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 $6,181.
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 Children's Healthcare of Atlanta at Scottish Rite 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.