CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Franciscan Health Michigan City

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $3,066
Cash Discount Price: $1,507
vs. Medicare Baseline: 12.58x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Franciscan Health Michigan City is $3,066. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,507. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 12.58x the Medicare baseline. Located in 3500 Franciscan Way, Michigan City, IN.

Cash / Self-Pay

$1,507

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,066

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: $1,507 (618%)

Insurance Median: $3,066 (1258%)

Cash: $1,507 (618% of Medicare)

Ins. Median: $3,066 (1258% 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 1258% of the Medicare baseline (a markup of 1158%). 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
Medicare (plans)	$252	103%
Blue Cross Blue Shield	$360 - $4,830	148%
Unicare [1150]	$360 - $871	148%
Mdwise [1175]	$505	207%
Medicaid / KanCare	$505 - $606	207%
Workers Comp [1172]	$505	207%
Managed Health Services [1302]	$520	213%
Aetna	$529	217%
Managed Care [2000]	$529 - $8,173	217%
Commercial [2001]	$1,051 - $5,835	431%
Cigna	$1,150 - $6,115	472%
Great West Insurance [1055]	$2,917 - $5,835	1197%
United Medical Resources [1158]	$3,066	1258%
United Medical Resources [1301]	$3,066 - $3,375	1258%
UnitedHealthcare	$3,066 - $3,375	1258%

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 $1,507.
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 Franciscan Health Michigan City 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.