CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Fayette County Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $476
Cash Discount Price: $554
vs. Medicare Baseline: 1.95x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Fayette County Hospital is $476. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $554. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.95x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.

Cash / Self-Pay

$554

Average discount available for prompt cash payment at this facility.

Insurance Median

$476

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: $554 (227%)

Insurance Median: $476 (195%)

Cash: $554 (227% of Medicare)

Ins. Median: $476 (195% 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
Aetna	$61 - $4,968	25%
Blue Cross Blue Shield	$61 - $6,048	25%
Illinicare - All Plans	$61 - $475	25%
Medicaid / KanCare	$61 - $475	25%
Meridian-All Plans	$61 - $475	25%
Health Alliance Mcare	$63 - $2,304	26%
Healthlink Mcr Adv	$63 - $2,304	26%
Cigna	$73 - $5,400	30%
Coventry/Ghp-All Plans	$85 - $4,680	35%
Multiplan - All Plans	$116 - $6,120	48%
Health Alliance - All Other Plans	$125 - $5,947	51%
UnitedHealthcare	$305 - $5,976	125%
Healthlink Hmo	$316 - $5,040	130%
Healthlink Ppo - All Other Plans	$316 - $5,760	130%
Humana	$1,536 - $2,304	630%

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 $554.
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 Fayette County 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.