CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mercyone Des Moines Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,360
  • Cash Discount Price: $3,185
  • vs. Medicare Baseline: 5.58x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mercyone Des Moines Medical Center is $1,360. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,185. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.58x the Medicare baseline. Located in 1111 6Th Ave, Des Moines, IA.
Cash / Self-Pay
$3,185

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,360

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: $3,185 (1307%)
Insurance Median: $1,360 (558%)
Cash: $3,185 (1307% of Medicare)
Ins. Median: $1,360 (558% 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 558% of the Medicare baseline (a markup of 458%). 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 $225 92%
Aetna $226 - $2,040 93%
Medicare (plans) $226 - $235 93%
Medicaid / KanCare $227 - $228 93%
Blue Cross Blue Shield $228 - $538 94%
UnitedHealthcare $230 - $5,880 94%
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%
Amish Hospital Aid $307 126%
Oscar $327 134%
Centivo $333 137%
Ambetter / Centene $387 159%
Claimdoc $463 190%
Nova $463 190%
Geha $525 - $1,051 215%
Health Choices $788 - $1,182 323%
Medical Associates $788 - $1,182 323%
1199 National Benefit Fund $1,360 - $2,040 558%
Allied Benefit Systems $1,360 - $2,040 558%
Asr Health Benefits $1,360 - $2,040 558%
Christian Brother Services $1,360 - $2,040 558%
Coventry $1,360 - $2,040 558%
First Health $1,360 - $2,040 558%
Lucent Health $1,360 - $2,040 558%
Luminare Health $1,360 - $2,040 558%
Medical Mutual $1,360 - $2,040 558%
Meritain $1,360 - $2,040 558%
Trustmark Small Business Benefits $1,360 - $2,040 558%
Webtpa $1,360 - $2,040 558%
Cigna $2,352 - $3,528 965%
Health Partners $2,489 - $3,734 1021%
Auxiant $2,548 - $3,822 1045%
Medica $2,548 - $3,822 1045%
Midlands $2,548 - $3,822 1045%
Midlands Choice $2,548 - $3,822 1045%
Usa Managed Care $3,332 - $4,998 1367%
Crime Victim Assistance $3,920 - $5,880 1608%
Iowa Dept Of Public Health $3,920 - $5,880 1608%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 6Th Ave, Des Moines, IA 50314
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals