CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Memorial Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,662
Cash Discount Price: $1,434
vs. Medicare Baseline: 6.82x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Memorial Hospital is $1,662. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,434. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.82x the Medicare baseline. Located in 4500 Memorial Drive, Belleville, IL.

Cash / Self-Pay

$1,434

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,662

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: $1,434 (588%)

Insurance Median: $1,662 (682%)

Cash: $1,434 (588% of Medicare)

Ins. Median: $1,662 (682% 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 682% of the Medicare baseline (a markup of 582%). 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
Blue Cross Blue Shield	$284 - $2,079	117%
Cigna	$644 - $993	264%
Apwu Health Plan [216]	$989	406%
Nalc Health Benefit Plan [242]	$989	406%
Priority Health [648]	$989	406%
Aetna	$1,017 - $1,792	417%
Allied Benefits [498]	$1,017 - $1,776	417%
Coresource [497]	$1,017	417%
Fmh Benefit Service Inc [222]	$1,017	417%
Mail Handlers [495]	$1,017	417%
Consociate [478]	$1,024	420%
Sarah Bush Lincoln [636]	$1,024	420%
Healthlink [225]	$1,159 - $1,804	475%
Cox Health Systems Insurance Company [220]	$1,314 - $1,769	539%
Hope Trust [806]	$1,386	569%
Med-Pay [480]	$1,554 - $1,792	637%
Unicare [568]	$1,554 - $1,804	637%
Humana	$1,663	682%
First Health Commercial [734]	$1,776	729%
UnitedHealthcare	$1,776 - $1,782	729%
Healthscope Benefits [258]	$1,782	731%
Beechstreet [551]	$1,792	735%
Detego Health [868]	$1,792	735%
Health Systems Inc [620]	$1,792	735%
Healthcare Sol Mercy [609]	$1,792	735%
Multiplan Commercial [737]	$1,792	735%
Multiplan [240]	$1,792	735%
Phcs [244]	$1,792 - $1,912	735%
Preferred Health Professionals [561]	$1,804	740%
Hfn [563]	$1,912	784%
Medica [661]	$1,912	784%
Health Alliance [224]	$2,250	923%

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 $1,434.
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 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.