CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mc Donough District Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $303
  • Cash Discount Price: $1,319
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mc Donough District Hospital is $303. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,319. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.24x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.
Cash / Self-Pay
$1,319

Average discount available for prompt cash payment at this facility.

Insurance Median
$303

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: $1,319 (541%)
Insurance Median: $303 (124%)
Cash: $1,319 (541% of Medicare)
Ins. Median: $303 (124% 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.

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
Health Alliance $37 - $3,575 15%
Hfn $58 - $3,615 24%
UnitedHealthcare $58 - $3,615 24%
Aetna $61 - $4,017 25%
Humana $61 - $3,615 25%
Medicaid / KanCare $61 - $4,017 25%
Medicare (plans) $61 - $270 25%
Meridian $61 - $270 25%
Molina $61 - $4,017 25%
Mutual Medical $61 - $4,017 25%
Veteran Affairs $61 - $270 25%
Tricare $252 103%
Blue Cross Blue Shield $303 - $4,017 124%
Springfield Health $312 - $3,294 128%
Consociate $323 - $3,414 133%
Trilogy $323 - $3,414 133%
Blue Choice $342 - $3,615 140%
Current Health $342 - $3,615 140%
Healthlink $342 - $3,776 140%
Preferred Plan $361 - $3,816 148%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals