CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Adventist Health Castle

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,688
Cash Discount Price: $734
vs. Medicare Baseline: 6.92x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Adventist Health Castle is $1,688. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $734. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.92x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$734

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,688

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: $734 (301%)

Insurance Median: $1,688 (692%)

Cash: $734 (301% of Medicare)

Ins. Median: $1,688 (692% 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 692% of the Medicare baseline (a markup of 592%). 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
Kfh Mcr Adv	$282	116%
Medicare (plans)	$282	116%
Ohana Health Plan - All Plans	$288	118%
Devoted Hlth Mcr Adv - All Plans	$296	121%
UnitedHealthcare	$396	162%
Alohacare Quest Mcaid - All Other Plans	$430 - $859	176%
Hmsa Hmo	$729	299%
Hmsa Ppo - All Other Plans	$729	299%
Pacific Admin Ppo - All Plans	$1,095 - $2,188	449%
Hwmg/Hmaa - All Plans	$1,267 - $2,533	520%
Mdx Hawaii Ppo - All Plans	$1,374 - $2,747	564%
Health Alliance - All Plans	$1,377 - $2,753	565%
Kfh - All Other Plans	$1,463 - $2,925	600%
Uni Health Alliance - All Plans	$1,606 - $3,210	659%
First Health Ppo - All Plans	$1,618 - $3,235	664%
Medicaid / KanCare	$1,721 - $3,441	706%
State Of Hi Nonprofit - All Plans	$3,012 - $6,022	1236%

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 $734.
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 Adventist Health Castle 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.