CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Northwest Health - Porter

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $666
  • Cash Discount Price: $1,463
  • vs. Medicare Baseline: 2.73x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Northwest Health - Porter is $666. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,463. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.73x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$1,463

Average discount available for prompt cash payment at this facility.

Insurance Median
$666

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: $1,463 (600%)
Insurance Median: $666 (273%)
Cash: $1,463 (600% of Medicare)
Ins. Median: $666 (273% 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 273% of the Medicare baseline (a markup of 173%). 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
Veterans Eval Services $222 91%
UnitedHealthcare $224 - $2,179 92%
Tricare $240 98%
Aetna $248 - $2,354 102%
Blue Cross Blue Shield $248 - $1,029 102%
Humana $248 - $505 102%
Medicare (plans) $248 - $265 102%
Node Mhs Mcr Adv $248 102%
Healthy Indiana Plan $252 103%
Node Hospice Non Par Agree $252 103%
Node Va $252 103%
Node Devoted Health Mcr Adv $253 104%
Care Improvement Plus $261 107%
In Dept Of Correction $263 108%
Node Us Dept Of Labor $316 130%
Align Network $404 166%
One Call Work Comp $404 166%
Encore Health $454 - $3,714 186%
Prime Health $454 - $3,482 186%
One Call $500 205%
Caresource $505 207%
Indiana Work Comp $505 207%
Lutheran Preferred $505 - $2,786 207%
Managed Health Services $505 207%
Medicaid / KanCare $505 207%
Mhs $505 207%
Node Encore Kba Epo $606 249%
Porter County $606 249%
Preferred Network Access $606 249%
Magnacare Ma $643 264%
Lutheran Preferred Chs Employees $1,114 457%
Self Pay $1,254 - $1,671 514%
Encore Ppo $1,260 517%
Cigna $1,291 530%
Physicians Health Plan $1,779 730%
Php Freedom $1,918 787%
Sagamore Health Network $2,052 - $2,749 842%
First Health Coventry $2,275 933%
Southeastem Indiana Health Operations $3,250 - $3,482 1333%
Network Synergy Group $3,482 1428%
Multiplan/Phcs $3,900 1600%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals