CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mercyone Elkader Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $3,830
  • Cash Discount Price: $3,253
  • vs. Medicare Baseline: 15.71x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mercyone Elkader Medical Center is $3,830. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,253. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 15.71x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$3,253

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,830

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: $3,253 (1334%)
Insurance Median: $3,830 (1571%)
Cash: $3,253 (1334% of Medicare)
Ins. Median: $3,830 (1571% 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 1571% of the Medicare baseline (a markup of 1471%). 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
Blue Cross Blue Shield $2,060 - $3,091 845%
Aetna $2,082 - $4,420 854%
Medicare (plans) $2,102 - $3,244 862%
UnitedHealthcare $2,206 - $4,504 905%
Iowa Total Care $2,491 - $3,736 1022%
Medicaid / KanCare $2,527 - $3,810 1037%
Amish Hospital Aid $2,768 - $4,153 1135%
1199 National Benefit Fund $2,946 - $4,420 1209%
Allied Benefit Systems $2,946 - $4,420 1209%
Asr Health Benefits $2,946 - $4,420 1209%
Christian Brother Services $2,946 - $4,420 1209%
Coventry $2,946 - $4,420 1209%
First Health $2,946 - $4,420 1209%
Lucent Health $2,946 - $4,420 1209%
Luminare Health $2,946 - $4,420 1209%
Medical Mutual $2,946 - $4,420 1209%
Meritain $2,946 - $4,420 1209%
Trustmark Small Business Benefits $2,946 - $4,420 1209%
Webtpa $2,946 - $4,420 1209%
Geha $3,002 - $4,504 1231%
Centivo $3,122 - $4,684 1281%
Health Choices $3,202 - $4,804 1314%
Medical Associates $3,202 - $4,804 1314%
Ambetter / Centene $3,497 - $5,246 1435%
Health Partners $3,851 - $5,777 1580%
Auxiant $3,923 - $5,885 1609%
Cigna $3,923 - $5,885 1609%
Medica $3,923 - $5,885 1609%
Midlands $3,923 - $5,885 1609%
Midlands Choice $3,923 - $5,885 1609%
Crime Victim Assistance $4,003 - $6,005 1642%
Iowa Dept Of Public Health $4,003 - $6,005 1642%
Claimdoc $4,184 - $6,276 1716%
Nova $4,184 - $6,276 1716%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 Davidson Street Nw, Elkader, IA 52043
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals