CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Madison County Health Care System

Billing Code: 73721 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,149

about 4.7× the $244 Medicare rate · typically $321–$1,614

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,032

Below the fair price — a good deal

about $117 under the fair price · 4.2× Medicare

Medicare pays $244 Fair price $1,149 This hospital $1,032 Cash price $2,668 Hospital's list price $3,335

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

Highest price of the 9 IA hospitals we have prices for — worth calling around.

Cheapest $60 Priciest $1,032

Black dot = this hospital, among the 9 IA hospitals with a price for this procedure. Full list below.

A fair price for a MRI, knee or other leg joint is about $1,149 (about 4.7× the $244 Medicare rate). Madison County Health Care System charges insurers about $1,032, or about $2,668 in cash — below the fair price — a good deal. Located in Winterset, IA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$1,425 - $3,021	585%
Blue Cross Blue Shieldmajor	$983 - $1,082	403%
Aetnamajor	$1,425 - $2,182	585%
Amerigroup	$1,651 - $1,672	677%
Molina	$1,612 - $1,633	661%
Oscar Health	$2,137 - $2,165	877%
+ 14 smaller / regional plans	$1,425 - $3,357

Government programs also on file: Military & VA.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 2,668), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 73721.

Insurance Before you use insurance

Call your insurance company to confirm Madison County Health Care System is in-network.
Ask your insurer whether prior approval is required for CPT code 73721.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Madison County Health Care System

Compare: MRI, knee or other leg joint at other IA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.