CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Woodlawn Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,381
  • Cash Discount Price: $3,808
  • vs. Medicare Baseline: 5.67x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Woodlawn Hospital is $1,381. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,808. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.67x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.
Cash / Self-Pay
$3,808

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,381

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: $3,808 (1562%)
Insurance Median: $1,381 (567%)
Cash: $3,808 (1562% of Medicare)
Ins. Median: $1,381 (567% 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 567% of the Medicare baseline (a markup of 467%). 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
Blue Cross Blue Shield $129 - $4,882 53%
Caresource Mcaid Hww $129 53%
Mdwise Excel Hhw & Hcc $129 53%
Mhs Mcaid Hcc $129 53%
Mhs Mcaid Hhw $129 53%
UnitedHealthcare $129 - $4,631 53%
Aetna $894 - $5,788 367%
Caresource Mcaid Hip $894 - $1,340 367%
Caresource Mcr Adv $894 - $1,340 367%
Humana $894 - $4,728 367%
Mdwise Mcaid Excel Hip $894 - $1,340 367%
Mhs Exch Mrktplce-All Other Plans $894 - $1,340 367%
Mhs Mcaid Hip $894 - $1,340 367%
Mhs Mcr Adv $912 - $1,367 374%
Caresource Exch - All Other Plans $1,162 - $1,743 477%
Ambetter / Centene $1,189 - $1,783 488%
Partners Direct Health-All Plans $2,762 - $4,143 1133%
Cigna $2,908 - $5,179 1193%
Parkview Health Plans-All Plans $3,046 - $4,570 1250%
Sagamore All Other Grps - All Other Plans $3,412 - $5,118 1400%
Encore Comm-All Plans $3,453 - $5,179 1416%
Phcs/Multiplan-All Plans $3,778 - $5,666 1550%
Community Health Alliance-All Plans $3,859 - $5,788 1583%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 E 9Th St, Rochester, IN 46975
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals