CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Bluffton Regional Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,120
  • Cash Discount Price: $2,229
  • vs. Medicare Baseline: 4.59x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Bluffton Regional Medical Center is $1,120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,229. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.59x the Medicare baseline. Located in 303 S Main St, Bluffton, IN.
Cash / Self-Pay
$2,229

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,120

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: $2,229 (914%)
Insurance Median: $1,120 (459%)
Cash: $2,229 (914% of Medicare)
Ins. Median: $1,120 (459% 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 459% of the Medicare baseline (a markup of 359%). 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 - $2,640 92%
Tricare $240 98%
Aetna $248 - $2,516 102%
Blue Cross Blue Shield $248 - $1,037 102%
Medicare (plans) $248 102%
Node Iu Health Mcr Adv $248 102%
Node Mhs Mcr Adv $248 102%
Department Of Veterans Affairs $252 103%
Humana $252 - $505 103%
Node Non Par Hospice Agree $252 103%
Node Va $252 103%
Northeast Hospice $252 103%
Node Caresource Mcr Adv $253 104%
Node Devoted Health Mcr Adv $253 104%
County Jail Health Care $263 108%
In Dept Of Correction $263 108%
Node Pphp Mcr Adv $265 109%
Us Department Of Labor $316 130%
Lutheran Advanced Network $379 155%
Lutheran Preferred Network $379 - $4,514 155%
Lutheran Three Rivers Preferred Plus 150 $379 155%
Lutheran Three Rivers Preferred Plus 175 $442 181%
Encore Work Comp In $454 186%
Prime Health Services $454 - $4,232 186%
Caresource $505 207%
Lutheran Northwest Health Preferred $505 207%
Managed Health Services Exchange $505 207%
Medicaid / KanCare $505 207%
Mhs $505 207%
Mhs In Hip $505 207%
Workers Compensation $505 207%
Php Freedom Network $593 243%
Encore Kba Epo $606 249%
Lutheran Trma $656 - $690 269%
Encore Kba Ppo $757 311%
Physicians Health Plan $843 346%
Php $952 391%
Sagamore Health Newtork Inc $1,203 - $3,024 493%
Amish Aid $1,354 555%
Self Pay $1,354 - $3,103 555%
Cigna $1,789 - $1,997 734%
Php Management Systems $2,185 896%
Encore Ppo $2,759 1132%
Sagamore Sebt $2,883 1183%
Consumer Life $3,498 1435%
Ahg Dana Employees $3,667 1504%
Align Networks $3,949 1620%
Private Healthcare Systems Inc $4,232 1736%
Multiplan $4,514 1852%
Encore Health Network $4,626 - $5,078 1898%
Advantage 360 $4,683 1921%
Community Health Alliance $4,796 1967%
First Health $4,852 1990%
Allied Benefit Systems $5,078 2083%
Cardinal Health Alliance $5,078 2083%
Ppom $5,078 2083%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 S Main St, Bluffton, IN 46714
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals