CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Witham Health Services

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $3,440
Cash Discount Price: $3,155
vs. Medicare Baseline: 14.11x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Witham Health Services is $3,440. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,155. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.11x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$3,155

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,440

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: $3,155 (1294%)

Insurance Median: $3,440 (1411%)

Cash: $3,155 (1294% of Medicare)

Ins. Median: $3,440 (1411% 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 1411% of the Medicare baseline (a markup of 1311%). 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
Blue Cross Blue Shield	$129 - $4,155	53%
Mdwise Health In-All Plans	$252	103%
Caresource Mcr Adv	$257	105%
Aetna	$260 - $3,904	107%
Caresource Indiana Marketplace-All Other Plans	$480	197%
UnitedHealthcare	$2,916 - $4,115	1196%
Phcs/Multiplan-All Plans	$3,403 - $4,801	1396%
Sagamore-All Plans	$3,440 - $4,854	1411%
Humana	$3,477 - $4,907	1426%
Beech Street-All Plans	$3,515 - $4,960	1442%
Encore-All Plans	$3,552 - $5,012	1457%
Mhs Comml Exch-All Plans	$9,348 - $13,191	3835%

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 $3,155.
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 Witham Health Services 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.