CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Madison County Health Care System

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $2,582
  • Cash Discount Price: $2,668
  • vs. Medicare Baseline: 10.59x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Madison County Health Care System is $2,582. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,668. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.59x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$2,668

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,582

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: $2,668 (1094%)
Insurance Median: $2,582 (1059%)
Cash: $2,668 (1094% of Medicare)
Ins. Median: $2,582 (1059% 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 1059% of the Medicare baseline (a markup of 959%). 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 $983 - $1,082 403%
Aetna $1,425 - $2,182 585%
Medical Associates Hp - All Plans $1,425 - $1,444 585%
Medigold-All Plans $1,425 - $1,444 585%
Tricare $1,425 - $1,444 585%
UnitedHealthcare $1,425 - $3,021 585%
American Hp Mcr Adv-All Plans $1,496 - $1,516 614%
Iowa Total Care Mcaid-All Plans $1,557 - $1,578 639%
Molina Mcaid/Chip -All Plans $1,612 - $1,633 661%
Amerigroup Mcaid-All Plans $1,651 - $1,672 677%
Madison County Sheriff-All Plans $1,656 - $1,678 679%
Oscar - All Plans $2,137 - $2,165 877%
Corvel Wc-All Plans $2,982 - $3,021 1223%
Choicecare-All Plans $3,147 - $3,189 1291%
First Choice-All Plans $3,147 - $3,189 1291%
First Health-All Plans $3,147 - $3,189 1291%
Integrated Hp-All Plans $3,147 - $3,189 1291%
Mutual Of Omaha-All Plans $3,147 - $3,189 1291%
Plaines Health-All Plans $3,147 - $3,189 1291%
Preferred Hlth Ntwork-All Plans $3,147 - $3,189 1291%
Principal Healthcare-All Plans $3,147 - $3,189 1291%
Usa Managed Care-All Plans $3,147 - $3,189 1291%
Medimore Employee Hp - All Plans $3,247 - $3,290 1332%
Midlands Choice - All Plans $3,247 - $3,290 1332%
Benefit Admin Of America-All Plans $3,313 - $3,357 1359%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals