CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Audubon County Memorial Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,620
Cash Discount Price: $2,000
vs. Medicare Baseline: 6.65x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Audubon County Memorial Hospital is $1,620. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,000. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.65x the Medicare baseline. Located in 515 Pacific Avenue, Audubon, IA.

Cash / Self-Pay

$2,000

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,620

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: $2,000 (820%)

Insurance Median: $1,620 (665%)

Cash: $2,000 (820% of Medicare)

Ins. Median: $1,620 (665% 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 665% of the Medicare baseline (a markup of 565%). 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	$725	297%
Wellmark Ppo - All Other Plans	$798	327%
UnitedHealthcare	$1,200	492%
Aetna	$1,440 - $1,800	591%
Tricare	$1,440	591%
Midlands Choice - All Plans	$1,960	804%
Molina Mcaid - All Plans	$2,000	820%
Iowa Total Care Mcaid - All Plans	$2,020	829%
Amerigroup Mcaid - All Plans	$2,100	861%

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 $2,000.
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 Audubon County Memorial 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.