CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Decatur County Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,924
  • Cash Discount Price: $1,924
  • vs. Medicare Baseline: 7.89x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Decatur County Hospital is $1,924. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,924. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.89x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$1,924

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,924

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: $1,924 (789%)
Insurance Median: $1,924 (789%)
Cash: $1,924 (789% of Medicare)
Ins. Median: $1,924 (789% 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 789% of the Medicare baseline (a markup of 689%). 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 $770 316%
Wellmark Hmo $983 403%
Champva -All Plans $1,082 444%
Wellmark Ppo - All Other Plans $1,082 444%
Everystep Hospice-All Plans $1,251 513%
Aetna $1,299 - $1,900 533%
Tricare $1,299 533%
UnitedHealthcare $1,443 - $2,044 592%
Benefit Admin System-All Plans $1,563 641%
Humana $1,756 720%
Meritain Health-All Plans $1,756 720%
Misc Commercial-All Plans $1,756 720%
All Savers-All Plans $1,804 740%
Allied Benefit System-All Plans $1,804 740%
American Family Ins Grp-All Plans $1,804 740%
Rural Carrier Benefit Plan-All Plans $1,852 760%
Christian Healthcare -All Plans $1,924 789%
Medica-All Other Plans $1,924 789%
Golden Rule-All Plans $2,044 838%
Ntca The Rural Broadband-All Plans $2,044 838%
Cigna $2,068 848%
Medical Mutual-All Plans $2,116 868%
Farm Bureau Financial-All Other Plans $2,164 888%
Farm Bureau Property And Ca $2,164 888%
Medi Share-All Plans $2,189 898%
Uhss-All Plans $2,189 898%
Health Partners-All Plans $2,213 908%
Lewermark-All Plans $2,285 937%
Mail Handlers Benefit-All Plans $2,357 967%
Midlands Choice-All Plans $2,357 967%
Priority Health-All Plans $2,405 987%
Iowa Total Care Mcaid-All Plans $2,453 1006%
Amerigroup Mcaid-All Plans $2,525 1036%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals