CMS Price Transparency Data

MRI, knee or other leg joint

Facility: St Joseph Health System, LLC

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $941
  • Cash Discount Price: $1,487
  • vs. Medicare Baseline: 3.86x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at St Joseph Health System, LLC is $941. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,487. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.86x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$1,487

Average discount available for prompt cash payment at this facility.

Insurance Median
$941

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: $1,487 (610%)
Insurance Median: $941 (386%)
Cash: $1,487 (610% of Medicare)
Ins. Median: $941 (386% 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 386% of the Medicare baseline (a markup of 286%). 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 - $2,021 92%
Tricare $240 98%
Aetna $248 - $2,560 102%
Blue Cross Blue Shield $248 - $1,366 102%
Humana $248 - $505 102%
Managed Health Services $248 - $505 102%
Medicare (plans) $248 102%
Department Of Veterans Affairs $252 103%
Node Hospice Non Par Agree $252 103%
Node Va $252 103%
Node Devoted Health Mcr Adv $253 104%
In Dept Of Correction $263 108%
Node Pphp Mcr Adv $265 109%
Us Department Of Labor $316 130%
Lutheran Advanced Network $379 155%
Lutheran Network $379 - $2,071 155%
Encore Work Comp In $454 186%
Prime Health Services $454 - $2,824 186%
Spreemo $500 205%
Caresource $505 207%
Medicaid / KanCare $505 207%
Work Comp $505 207%
Php Freedom Network $593 243%
Encore Kba Epo $606 249%
Lutheran Preferred $656 - $2,259 269%
Three Rivers $690 283%
Encore Kba Ppo $757 311%
Php $843 - $1,504 346%
Amish Aid $904 371%
Self Pay $904 - $2,071 371%
Sagamore $1,203 493%
Cigna $1,216 - $3,765 499%
Encore Ppo $1,304 - $3,388 535%
Multiplan $2,598 - $2,937 1066%
First Health $2,824 1158%
Align Network $3,012 1236%
Frontpath Health Coalition $3,012 1236%
Advantage Health Solutions $3,125 1282%
Allied Benefit Systems $3,388 1390%
Medical Mutual Of Ohio $3,765 1544%
Parkview Healthplan Services $3,765 1544%
Value Options $3,765 1544%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 702 Van Buren St., Fort Wayne, IN 46802
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals