CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Stormont Vail Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $222
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Stormont Vail Hospital is $222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.91x the Medicare baseline. Located in 1500 Sw 10Th Avenue, Topeka, KS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$222

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%)
Insurance Median: $222 (91%)
Ins. Median: $222 (91% 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.

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
Ambetter / Centene $134 - $238 55%
UnitedHealthcare $134 - $238 55%
Blue Cross Blue Shield $135 - $705 55%
Humana $218 - $222 89%
Aetna $218 - $222 89%

Consumer Guidance & Cost Commentary

For the MRI of a knee or other leg joint at Stormont Vail Hospital in Topeka, KS, the negotiated payment rate is $238.00, which is 90% of the Medicare-approved amount of $243.77. This rate is significantly lower than the highest negotiated rates seen across Kansas for this procedure, where some payers have negotiated amounts exceeding $705. While the facility's negotiated rate is competitive compared to the state's high-end contracts, patients should be aware that cash-pay options are often the most economical choice. Although the cash median is not listed in this report, patients with high-deductible plans may find that paying out-of-pocket avoids the administrative overhead and markup inherent in insurance billing cycles. It is always advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can further reduce the final cost before any insurance claim is processed.

Patients should exercise caution regarding balance billing and ensure they receive an itemized bill to avoid unexpected charges. Under the No Surprises Act, balance billing for emergency care and non-emergency services at in-network facilities is prohibited, but patients must verify that all ancillary services, such as specific lab tests or imaging components, are covered under the facility's network agreements. If a summary bill is received, it is critical to request a full itemized statement that lists every CPT code and unit cost to identify potential errors, unbundled charges, or services not rendered. Since over 80% of hospital bills contain errors, disputing these discrepancies in writing with the billing supervisor is the most effective way to reduce medical debt. By comparing the facility's rates against the Medicare benchmark and actively seeking prompt-pay discounts

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 Sw 10Th Avenue, Topeka, KS 66604
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals