MRI, knee or other leg joint
Facility: Pratt Regional Medical Center
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $286
- Cash Discount Price: $1,034
- vs. Medicare Baseline: 1.17x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Christian Health Aid | $215 - $2,001 | 88% |
| Celtic Insurance Company | $227 | 93% |
| Healthy Blue | $234 | 96% |
| UnitedHealthcare | $238 - $2,721 | 98% |
| Health Partners Of Kansas | $243 - $2,268 | 100% |
| Aetna | $257 - $2,401 | 105% |
| Choicecare | $286 - $2,668 | 117% |
Consumer Guidance & Cost Commentary
For the CPT code 73721, representing an MRI of the knee or other leg joint, Pratt Regional Medical Center in Pratt, KS, lists a gross charge of $1,477.00. While the facility offers a cash median price of $1,034.00, commercial insurance negotiated rates vary significantly by carrier, ranging from $215 to $2,721. Notably, the median negotiated rate across all payers is $286.00, which is substantially lower than the cash price. This pricing structure suggests that for patients with high-deductible plans or those without immediate cash flow, utilizing an in-network insurance plan may result in a lower out-of-pocket cost compared to paying cash directly, as the insurance negotiated ceiling often caps the charge below the cash-pay rate.
To ensure you are receiving the most accurate billing information, it is critical to request an itemized bill before finalizing payment, as summary bills can obscure individual line items and potential errors. Additionally, patients should verify if the facility offers a prompt-pay discount, which could further reduce the cash price. While the facility holds a 4-star rating and is a Proprietary Acute Care Hospital, the specific Medicare benchmark for this service is $243.77. The commercial negotiated rate of $286.00 is approximately 1.17 times the Medicare amount, which falls within the typical range of fair pricing (120% to 150% of Medicare), whereas the gross charge represents a significant markup. Always confirm your specific plan's deductible status and allowed amount with the hospital prior to scheduling to avoid unexpected balance billing.