CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Ascension St Vincent Carmel

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $148
Cash Discount Price: $874
vs. Medicare Baseline: 0.61x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Ascension St Vincent Carmel is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $874. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.61x the Medicare baseline. Located in 13500 N Meridian St, Carmel, IN.

Cash / Self-Pay

$874

Average discount available for prompt cash payment at this facility.

Insurance Median

$148

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: $874 (359%)

Insurance Median: $148 (61%)

Cash: $874 (359% of Medicare)

Ins. Median: $148 (61% 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.

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	$49 - $647	20%
Medicaid / KanCare	$49 - $175	20%
Mhs Care Connect	$49 - $175	20%
UnitedHealthcare	$62 - $479	25%
Aetna	$148 - $700	61%
Ambetter / Centene	$148	61%
Ascension Complete Mcr	$148	61%
Caresource Marketplace	$148	61%
Corizon	$148	61%
Humana	$148	61%
Immergrun	$148	61%
Medicare (plans)	$148	61%
Personalized Care	$148	61%
Secure Horizons-Pacificare	$148	61%
Smarthealth Ppo	$266	109%
Smarthealth Ppo/Hdhp 20161001	$266	109%
Encore Exclusive	$311	128%
Patoka Valley Tier 1	$311	128%
Patoka Valley Tier 2	$311	128%

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 $874.
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 Ascension St Vincent Carmel 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.