CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Franklin General Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,255
Cash Discount Price: $3,731
vs. Medicare Baseline: 9.25x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Franklin General Hospital is $2,255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,731. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.25x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$3,731

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,255

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: $3,731 (1531%)

Insurance Median: $2,255 (925%)

Cash: $3,731 (1531% of Medicare)

Ins. Median: $2,255 (925% 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 925% of the Medicare baseline (a markup of 825%). 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
Wellmark Hmo	$983	403%
Wellmark Ppo - All Other Plans	$1,082	444%
Medical Associates Mcare	$1,106 - $2,210	454%
Mount Carmel Hp-All Plans	$1,106 - $2,210	454%
Tricare	$1,106 - $2,210	454%
UnitedHealthcare	$1,106 - $4,592	454%
Amerigroup Mcare	$1,117 - $2,232	458%
Wellmark Mcr Adv	$1,117 - $2,232	458%
Molina Mcare	$1,151 - $2,299	472%
Ambetter / Centene	$1,157 - $3,537	475%
American Hp Iowa - All Plans	$1,162 - $2,321	477%
Amerigroup Mcaid - All Other Plans	$1,168 - $2,334	479%
Molina Mcaid - All Other Plans	$1,174 - $2,345	482%
Centivo - All Plans	$1,660 - $3,316	681%
Medical Ass Hosp Employer Group	$1,660 - $3,316	681%
Oscar - All Plans	$1,660 - $3,316	681%
Midlands Choice-All Plans	$1,936 - $3,868	794%
Medical Associates Hp-All Other Plans	$2,351 - $4,697	964%
Preferred Health Choices-All Plans	$2,351 - $4,697	964%
Splashlight Llc-All Plans	$2,351 - $4,697	964%
Aetna	$2,572 - $5,250	1055%
Multiplan-All Plans	$2,628 - $5,250	1078%

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 $3,731.
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 Franklin General Hospital 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.