CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Carle Eureka Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,174
Cash Discount Price: $4,830
vs. Medicare Baseline: 8.92x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Carle Eureka Hospital is $2,174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,830. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.92x the Medicare baseline. Located in 101 S Major St, Eureka, IL.

Cash / Self-Pay

$4,830

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,174

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: $4,830 (1981%)

Insurance Median: $2,174 (892%)

Cash: $4,830 (1981% of Medicare)

Ins. Median: $2,174 (892% 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 892% of the Medicare baseline (a markup of 792%). 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	$120 - $3,193	49%
Humana	$248 - $2,174	102%
Wellcare	$256	105%
Meridian	$483 - $2,318	198%
Molina	$966 - $2,318	396%
Cigna	$1,200	492%
UnitedHealthcare	$2,174 - $2,200	892%
Community Partners Health Plan (Cphp)	$2,898	1189%
Healthlink	$3,140	1288%
Blue Cross Blue Shield	$3,236 - $4,057	1327%
Multiplan/Phcs	$3,622	1486%

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 $4,830.
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 Eureka 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.