CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Cass County Memorial Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,102
Cash Discount Price: $1,819
vs. Medicare Baseline: 4.52x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Cass County Memorial Hospital is $1,102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,819. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.52x the Medicare baseline. Located in 1501 East Tenth Street, Atlantic, IA.

Cash / Self-Pay

$1,819

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,102

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: $1,819 (746%)

Insurance Median: $1,102 (452%)

Cash: $1,819 (746% of Medicare)

Ins. Median: $1,102 (452% 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 452% of the Medicare baseline (a markup of 352%). 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
UnitedHealthcare	$315 - $1,091	129%
Midlands Choice Medica Mcr	$520	213%
Wellmark Hmo	$763	313%
Wellmark Ppo - All Other Plans	$839	344%
Triwest - All Plans	$1,058	434%
Aetna	$1,091 - $2,468	448%
Amerigroup Mcr Adv - All Other Plans	$1,091	448%
Medica Mcr Adv	$1,091	448%
Tricare	$1,091	448%
Va Ccn - All Plans	$1,091	448%
Wellmark Mcr Adv	$1,102	452%
Iowa Total Care Mcaid	$1,113	457%
Iowa Total Care Mcr	$1,113	457%
Molina Mcaid - All Plans	$1,113	457%
American Hlth Mcr Adv - All Plans	$1,124	461%
Medicaid / KanCare	$1,124	461%
Iowa Total Care Comm - All Other Plans	$1,200	492%
Midlands Choice New Bus	$1,689	693%
Medica Comm - All Other Plans	$2,286	938%
Midlands Choice Pho (Ppo) - All Other Plans	$2,338	959%
Multiplan - All Plans	$2,468	1012%

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 $1,819.
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 Cass 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.