CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Clearwater Valley Hospital & Clinics

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,052
Cash Discount Price: $858
vs. Medicare Baseline: 4.32x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Clearwater Valley Hospital & Clinics is $1,052. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $858. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.32x the Medicare baseline. Located in 301 Cedar Street, Orofino, ID.

Cash / Self-Pay

$858

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,052

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: $858 (352%)

Insurance Median: $1,052 (432%)

Cash: $858 (352% of Medicare)

Ins. Median: $1,052 (432% 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 432% of the Medicare baseline (a markup of 332%). 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
Cigna	$54 - $3,472	22%
Humana	$60 - $3,742	25%
Nimiipuu Mcr Adv-All Plans	$60 - $2,104	25%
Regence Blue Shield Mcr	$60 - $2,083	25%
Veterans Amin-All Plans	$60 - $2,083	25%
Pacific Source - All Plans	$62 - $2,083	25%
Blue Cross Blue Shield	$69 - $2,816	28%
Aetna	$96 - $3,588	39%
UnitedHealthcare	$114	47%
Idaho Phys Network-All Plans	$171 - $3,665	70%
Multiplan / Phcs-All Plans	$173 - $3,742	71%
Geha-All Plans	$175 - $3,781	72%
First Choice-All Plans	$176 - $3,781	72%
Corizon Correctnal Med-All Plans	$207 - $2,816	85%
Regence Blue Shield-All Other Plans	$1,929 - $3,858	791%

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 $858.
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 Clearwater Valley Hospital & Clinics 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.