CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Warner Hospital and Health Services

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $3,221
Cash Discount Price: $3,957
vs. Medicare Baseline: 13.21x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Warner Hospital and Health Services is $3,221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,957. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 13.21x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$3,957

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,221

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: $3,957 (1623%)

Insurance Median: $3,221 (1321%)

Cash: $3,957 (1623% of Medicare)

Ins. Median: $3,221 (1321% 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 1321% of the Medicare baseline (a markup of 1221%). 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
Aetna	$915 - $3,468	375%
Blue Cross Blue Shield	$915 - $3,999	375%
Harmony Hp Mcaid-All Plans	$915	375%
Medicaid / KanCare	$915	375%
Meridian Hp-All Plans	$915	375%
Molina-All Other Plans	$915	375%
Health Alliance Med Adv	$1,572 - $1,673	645%
Humana	$1,572 - $3,468	645%
Molina Mcr/Mcd Dual	$1,572 - $1,673	645%
UnitedHealthcare	$1,572 - $3,468	645%
Wellcare Mcr Adv-All Plans	$1,572 - $1,673	645%
Healthlink Hmo	$2,990 - $3,183	1227%
City Of Clinton (Employees Serv)-All Plans	$3,067 - $3,264	1258%
Cigna	$3,182 - $3,387	1305%
Caterpillar-All Plans	$3,259 - $3,468	1337%
Multiplan Phcs-All Plans	$3,259 - $3,468	1337%
Health Alliance-All Other Plans	$3,374 - $3,591	1384%
Healthlink Ppo/Work Comp-All Other Plans	$3,374 - $3,591	1384%
Consociate Care Ppo-All Plans	$3,450 - $3,672	1415%
Hfn Ppo/Epo-All Plans	$3,450 - $3,672	1415%
Three Rivers-All Plans	$3,642 - $3,876	1494%

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 $3,957.
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 Warner Hospital and Health Services 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.