CMS Price Transparency Data

MRI, knee or other leg joint

Facility: St Joseph's Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $2,620
  • Cash Discount Price: $2,946
  • vs. Medicare Baseline: 10.75x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at St Joseph's Hospital is $2,620. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,946. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.75x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$2,946

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,620

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: $2,946 (1209%)
Insurance Median: $2,620 (1075%)
Cash: $2,946 (1209% of Medicare)
Ins. Median: $2,620 (1075% 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 1075% of the Medicare baseline (a markup of 975%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Molina Healthcare $487 - $818 200%
Meridian Health Plan $510 209%
Humana $818 336%
Clear Spring Health of Illinois $818 336%
Sae Hospice $818 336%
Blue Cross Blue Shield $818 336%
UnitedHealthcare $818 - $4,092 336%
Aetna $818 - $2,860 336%
Amish Community $1,146 470%
Naphcare $1,719 705%
Celtic Insurance Company $1,800 738%
Cigna $1,929 791%
Claim Doc $2,046 839%
Hopetrust $2,046 839%
Caterpillar, Inc. $2,359 968%
Wellfirst $2,620 1075%
First Health $3,024 1241%
Multiplan/Phcs $3,478 1427%
Healthlink $3,478 1427%
Provider Network of America $3,683 1511%
Healthcare Finest Network (Hfn) $3,683 1511%
Health Alliance Medical Plans $4,092 1679%
Illinois Breast and Cervical Cancer Program $4,092 1679%
Healthscope $4,092 1679%
Mental Health Network $4,092 1679%
Current Health Solutions $4,092 1679%
Qtc Medical Group of Illinois $4,092 1679%
Consociate Group $4,092 1679%
Interplan $4,092 1679%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals