CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Gibson General Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $547
  • Cash Discount Price: $984
  • vs. Medicare Baseline: 2.24x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Gibson General Hospital is $547. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $984. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.24x the Medicare baseline. Located in 1808 Sherman Drive, Princeton, IN.
Cash / Self-Pay
$984

Average discount available for prompt cash payment at this facility.

Insurance Median
$547

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: $984 (404%)
Insurance Median: $547 (224%)
Cash: $984 (404% of Medicare)
Ins. Median: $547 (224% 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 224% of the Medicare baseline (a markup of 124%). 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 $55 - $1,300 23%
Caresource In Marketplace $96 - $1,031 39%
Ky Racing Health & Welfare Fund $96 - $1,003 39%
Self-Pay $96 - $984 39%
Aetna $127 - $1,450 52%
Ambetter / Centene $127 - $594 52%
Blue Cross Blue Shield $127 - $1,411 52%
Caresource Just For Me $127 - $594 52%
Medicare (plans) $127 - $594 52%
Meridiancomplete (Il) $127 - $594 52%
Mytruadvantage $127 - $594 52%
Va Ccn $127 - $594 52%
Medicaid / KanCare $130 53%
Meridiancare (Il) $130 - $594 53%
Meridianhealth (Il) $130 53%
Caresource $131 54%
Mdwise Plans $131 54%
Mhs $131 54%
Alliance Coal $165 - $739 68%
Chambercare $165 - $739 68%
Cigna $165 - $1,634 68%
Claimdoc $165 - $1,578 68%
Deaconess Onecare $165 - $1,541 68%
Hopetrust $165 - $1,578 68%
Hstechnology $165 - $1,578 68%
Sagamore (Ppo, Oap-Open Access Plus, Epo, Choice Fund Oap+) $165 - $1,634 68%
First Health $192 - $1,671 79%
Healthlink Hmo $192 - $1,671 79%
Healthlink Ppo $192 - $1,671 79%
Noncontracted $204 - $951 84%
Encircle/Encore Combined $206 - $1,578 85%
Encircle/Encore Prime $206 - $529 85%
Gibson County Sheriff $234 - $1,578 96%
Integrated Health $248 - $1,671 102%
Principal Health Care $248 - $1,671 102%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1808 Sherman Drive, Princeton, IN 47670
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals