CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Carle Foundation Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,673
Cash Discount Price: $5,576
vs. Medicare Baseline: 6.86x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Carle Foundation Hospital is $1,673. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,576. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.86x the Medicare baseline. Located in 611 West Park Street, Urbana, IL.

Cash / Self-Pay

$5,576

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,673

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: $5,576 (2287%)

Insurance Median: $1,673 (686%)

Cash: $5,576 (2287% of Medicare)

Ins. Median: $1,673 (686% 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 686% of the Medicare baseline (a markup of 586%). 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
Humana	$248 - $256	102%
Aetna	$256 - $4,472	105%
Blue Cross Blue Shield	$256 - $3,624	105%
Meridian	$256 - $558	105%
Molina	$256 - $1,673	105%
UnitedHealthcare	$256 - $3,452	105%
Wellcare	$256	105%
Community Partners Health Plan (Cphp)	$3,281	1346%
Cigna	$4,349	1784%
Multiplan/Phcs	$4,461	1830%
Healthlink	$4,740	1944%

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 $5,576.
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 Carle Foundation 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.