CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Kirby Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $392
Cash Discount Price: $3,300
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Kirby Medical Center is $392. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,300. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.61x the Medicare baseline. Located in 1000 Medical Center Drive, Monticello, IL.

Cash / Self-Pay

$3,300

Average discount available for prompt cash payment at this facility.

Insurance Median

$392

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: $3,300 (1354%)

Insurance Median: $392 (161%)

Cash: $3,300 (1354% of Medicare)

Ins. Median: $392 (161% 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.

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	$50 - $5,390	21%
Aetna	$63 - $3,850	26%
Meridian	$63 - $1,705	26%
UnitedHealthcare	$63 - $3,790	26%
Wellcare	$63 - $1,705	26%
Molina	$65 - $1,756	27%
Zelis (Hfn)	$78 - $4,950	32%
Catepillar, Inc.	$125 - $4,675	51%
Humana	$263 - $4,125	108%
Healthlink	$392 - $4,950	161%
Multiplan/Phcs	$392 - $5,225	161%
Cigna	$4,400	1805%

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 $3,300.
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 Kirby Medical Center 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.