CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mahaska Health Partnership

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $801
Cash Discount Price: $1,245
vs. Medicare Baseline: 3.29x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mahaska Health Partnership is $801. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,245. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.29x the Medicare baseline. Located in 1229 C Avenue East, Oskaloosa, IA.

Cash / Self-Pay

$1,245

Average discount available for prompt cash payment at this facility.

Insurance Median

$801

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: $1,245 (511%)

Insurance Median: $801 (329%)

Cash: $1,245 (511% of Medicare)

Ins. Median: $801 (329% 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 329% of the Medicare baseline (a markup of 229%). 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
Aetna	$60 - $2,668	25%
Amerigroup Mcr Adv	$60 - $1,512	25%
Humana	$60 - $1,512	25%
UnitedHealthcare	$60 - $1,774	25%
Iowa Total Care Mcr	$62 - $1,512	25%
Iowa Total Care Comm - All Other Plans	$69 - $1,512	28%
Midlands Choice - All Plans	$138 - $2,668	57%
Medicaid / KanCare	$180 - $1,128	74%
Molina Mcaid - All Plans	$180 - $1,128	74%
Wellmark Hmo	$763	313%
Wellmark Ppo - All Other Plans	$839	344%

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 $1,245.
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 Mahaska Health Partnership 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.