CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Methodist Jennie Edmundson

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $598
Cash Discount Price: $900
vs. Medicare Baseline: 2.45x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Methodist Jennie Edmundson is $598. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $900. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.45x the Medicare baseline. Located in 933 East Pierce Street, Council Bluffs, IA.

Cash / Self-Pay

$900

Average discount available for prompt cash payment at this facility.

Insurance Median

$598

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: $900 (369%)

Insurance Median: $598 (245%)

Cash: $900 (369% of Medicare)

Ins. Median: $598 (245% 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 245% of the Medicare baseline (a markup of 145%). 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
Medicare (plans)	$189 - $1,500	78%
Aetna	$240 - $1,801	98%
Humana	$240	98%
Blue Cross Blue Shield	$244 - $1,951	100%
Medica	$244 - $1,588	100%
UnitedHealthcare	$244 - $1,801	100%
Elite Choice - Mje	$362 - $498	149%
Ambetter / Centene	$394 - $505	162%
Midlands Choice	$485 - $2,101	199%
Wellmark	$598 - $657	245%
Ne Furniture Mart	$1,380 - $1,801	566%
Medica Choice	$1,500 - $1,868	615%

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 $900.
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 Methodist Jennie Edmundson 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.