CMS Price Transparency Data

MRI, knee or other leg joint

Facility: St Francis Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $3,223
Cash Discount Price: $3,006
vs. Medicare Baseline: 13.22x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at St Francis Hospital is $3,223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,006. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 13.22x the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$3,006

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,223

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: $3,006 (1233%)

Insurance Median: $3,223 (1322%)

Cash: $3,006 (1233% of Medicare)

Ins. Median: $3,223 (1322% 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 1322% of the Medicare baseline (a markup of 1222%). 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
Wexford	$299	123%
Molina Healthcare	$314 - $921	129%
Meridian Health Plan	$329	135%
Humana	$877	360%
Blue Cross Blue Shield	$877 - $960	360%
Clear Spring Health of Illinois	$877	360%
UnitedHealthcare	$918 - $4,175	377%
Aetna	$918 - $2,935	377%
Amish Community	$1,169	480%
Celtic Insurance Company	$2,113	867%
Claim Doc	$2,192	899%
Hopetrust	$2,401	985%
Wellfirst	$2,686	1102%
Cigna	$2,862	1174%
First Health	$3,098	1271%
Caterpillar, Inc.	$3,348	1373%
Current Health Solutions	$3,507	1439%
Multiplan/Phcs	$3,549	1456%
Consociate Group	$3,549	1456%
Healthlink	$3,561	1461%
Healthcare Finest Network (Hfn)	$3,758	1542%
Provider Network of America	$3,758	1542%
Health Alliance Medical Plans	$4,175	1713%
Live360	$4,175	1713%
Interplan	$4,175	1713%
Naphcare	$4,175	1713%
Illinois Breast and Cervical Cancer Program	$4,175	1713%
Healthscope	$4,175	1713%

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 $3,006.
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 St Francis 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.