CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Pulaski Memorial Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,791
  • Cash Discount Price: $2,153
  • vs. Medicare Baseline: 7.35x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Pulaski Memorial Hospital is $1,791. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,153. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.35x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.
Cash / Self-Pay
$2,153

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,791

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: $2,153 (883%)
Insurance Median: $1,791 (735%)
Cash: $2,153 (883% of Medicare)
Ins. Median: $1,791 (735% 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 735% of the Medicare baseline (a markup of 635%). 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
UnitedHealthcare $56 - $5,839 23%
Ambetter / Centene $60 - $2,291 25%
Blue Cross Blue Shield $60 - $4,756 25%
Caresource Mcaid Hip $60 - $2,291 25%
Caresource Mcare Hmo $60 - $2,291 25%
Cenpatico Mcaid Hip $60 - $2,291 25%
Humana $60 - $5,943 25%
Mdwise Mcaid Hcc $60 - $129 25%
Mdwise Mcaid Hhw $60 - $129 25%
Mdwise Mcaid Hip - All Other Plans $60 - $2,291 25%
Mhs Mcaid Hip $60 - $2,291 25%
Mhs Mcare Allwell $60 - $2,314 25%
Multiplan - All Plans $60 - $6,652 25%
Caresource Exch Hmo Hix - All Other Plans $76 - $2,864 31%
Encore Ppo - All Other Plans $92 - $6,283 38%
Cigna $107 - $7,022 44%
Sagamore - All Other Plans $107 - $5,588 44%
Sagamore Rose Acre $107 - $5,507 44%
Community Health Alliance - All Plans $119 - $6,578 49%
Caresource Mcaid Hhw $129 - $187 53%
Cenpatico Mcaid Hhw - All Other Plans $129 - $187 53%
Mhs Mcaid Hhw/Hcc $129 - $187 53%
Encore Workers Comp $169 - $6,652 69%
Aetna $2,080 - $2,661 853%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 616 E 13Th St, Winamac, IN 46996
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals