CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mercyone Clinton Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,051
  • Cash Discount Price: $1,864
  • vs. Medicare Baseline: 4.31x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mercyone Clinton Medical Center is $1,051. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,864. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.31x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$1,864

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,051

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: $1,864 (765%)
Insurance Median: $1,051 (431%)
Cash: $1,864 (765% of Medicare)
Ins. Median: $1,051 (431% 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 431% of the Medicare baseline (a markup of 331%). 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
Iowa Total Care $220 90%
Medicaid / KanCare $222 - $223 91%
Bcn Domestic $244 - $538 100%
Blue Benefit Administrators Of Massachusetts $244 - $538 100%
Blue Care Network $244 - $538 100%
Blue Cross Blue Shield $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%
Aetna $249 - $3,012 102%
Medicare (plans) $249 - $259 102%
UnitedHealthcare $254 - $3,442 104%
Amish Hospital Aid $338 139%
Oscar $347 142%
Ambetter / Centene $427 175%
Claimdoc $511 210%
Nova $511 210%
Geha $525 - $1,051 215%
Health Choices $649 - $974 266%
Medical Associates $649 - $974 266%
Preferred Health Choice $663 - $995 272%
The Alliance $1,391 - $2,088 571%
1199 National Benefit Fund $2,007 - $3,012 823%
Allied Benefit Systems $2,007 - $3,012 823%
Asr Health Benefits $2,007 - $3,012 823%
Christian Brother Services $2,007 - $3,012 823%
Coventry $2,007 - $3,012 823%
First Health $2,007 - $3,012 823%
Lucent Health $2,007 - $3,012 823%
Luminare Health $2,007 - $3,012 823%
Medical Mutual $2,007 - $3,012 823%
Meritain $2,007 - $3,012 823%
Trustmark Small Business Benefits $2,007 - $3,012 823%
Webtpa $2,007 - $3,012 823%
Health Partners $2,012 - $3,019 825%
Auxiant $2,065 - $3,098 847%
Cigna $2,065 - $3,098 847%
Medica $2,065 - $3,098 847%
Midlands $2,065 - $3,098 847%
Midlands Choice $2,065 - $3,098 847%
Multiplan $2,065 - $3,098 847%
Qualcare $2,065 - $3,098 847%
Usa Managed Care $2,179 - $3,270 894%
Crime Victim Assistance $2,294 - $3,442 941%
Iowa Dept Of Public Health $2,294 - $3,442 941%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals