CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mercyone Waterloo Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $538
  • Cash Discount Price: $3,907
  • vs. Medicare Baseline: 2.21x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mercyone Waterloo Medical Center is $538. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,907. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.21x the Medicare baseline. Located in 3421 West Ninth Street, Waterloo, IA.
Cash / Self-Pay
$3,907

Average discount available for prompt cash payment at this facility.

Insurance Median
$538

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: $3,907 (1603%)
Insurance Median: $538 (221%)
Cash: $3,907 (1603% of Medicare)
Ins. Median: $538 (221% 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 221% of the Medicare baseline (a markup of 121%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $225 - $947 92%
Medicare (plans) $225 - $234 92%
Blue Cross Blue Shield $227 - $538 93%
Iowa Total Care $229 94%
UnitedHealthcare $229 - $7,212 94%
Medicaid / KanCare $231 - $232 95%
Bcn Domestic $244 - $538 100%
Blue Benefit Administrators Of Massachusetts $244 - $538 100%
Blue Care Network $244 - $538 100%
Blue Distinction Transplant $244 - $538 100%
Blue Shield - Ca $244 - $538 100%
Blue Shield - Id (Regence) $244 - $538 100%
Blue Shield - Ny Highmark Northeastern $244 - $538 100%
Blue Shield - Ny Highmark Western $244 - $538 100%
Blue Shield - Pa (Highmark) $244 - $538 100%
Blue Shield - Wa (Regence) $244 - $538 100%
Kaiser Domestic $244 - $538 100%
Pre-Employment $244 - $538 100%
Wc Domestic $244 - $538 100%
Amish Hospital Aid $305 125%
Oscar $352 144%
Centivo $381 156%
Ambetter / Centene $385 158%
Claimdoc $461 189%
Nova $461 189%
Geha $525 - $1,051 215%
Allied Benefit Systems $947 388%
Asr Health Benefits $947 388%
Christian Brother Services $947 388%
Coventry $947 388%
First Health $947 388%
Lucent Health $947 388%
Luminare Health $947 388%
Medical Mutual $947 388%
Meritain $947 388%
Webtpa $947 388%
Health Choices $1,130 - $1,695 464%
Medical Associates $1,130 - $1,695 464%
Health Partners $3,154 - $4,731 1294%
Auxiant $3,414 - $5,121 1401%
Cigna $3,414 - $5,121 1401%
Medica $3,414 - $5,121 1401%
Midlands $3,414 - $5,121 1401%
Midlands Choice $3,414 - $5,121 1401%
Iowa Dept Of Public Health $4,808 - $7,212 1972%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3421 West Ninth Street, Waterloo, IA 50702
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals