CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Rush Memorial Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,294
Cash Discount Price: $1,744
vs. Medicare Baseline: 5.31x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Rush Memorial Hospital is $1,294. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,744. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.31x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$1,744

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,294

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: $1,744 (715%)

Insurance Median: $1,294 (531%)

Cash: $1,744 (715% of Medicare)

Ins. Median: $1,294 (531% 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 531% of the Medicare baseline (a markup of 431%). 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
UnitedHealthcare	$53 - $3,426	22%
Caresource Mcr Adv	$60 - $1,328	25%
Humana	$60 - $3,940	25%
Aetna	$61 - $3,940	25%
Blue Cross Blue Shield	$62 - $3,346	25%
Today'S Option Mcr Adv-All Plans	$62 - $1,367	25%
Viant Beech St Mcr Adv	$62 - $1,367	25%
My True Advantage - All Plans	$63 - $1,328	26%
Consumers Life Ins-All Plans	$65 - $3,854	27%
Caresource Marketplace-All Other Plans	$82 - $2,124	34%
Multiplan-All Plans	$83 - $3,983	34%
Encore Health Services-All Plans	$104 - $4,197	43%
Siho-All Plans	$104 - $3,940	43%
Phcs-All Plans	$147 - $3,426	60%
Cigna	$185 - $1,969	76%
Health Net	$185 - $1,261	76%
Coventry/First Health-All Plans	$259 - $3,854	106%
Sagamore-All Plans	$3,940	1616%
Community Health Alliance-All Plans	$4,026	1652%

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 $1,744.
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 Rush Memorial Hospital 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.