MRI, knee or other leg joint
Facility: Nmc Health
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $2,180
- Cash Discount Price: $2,090
- vs. Medicare Baseline: 8.94x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 894% of the Medicare baseline (a markup of 794%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Bluestem Pace | $225 | 92% |
| Leading Age | $361 | 148% |
| Medicaid / KanCare | $361 | 148% |
| Blue Cross Blue Shield | $553 | 227% |
| Aetna | $872 - $2,395 | 358% |
| Wppa | $1,599 - $3,193 | 656% |
| Occunet | $1,744 - $3,484 | 715% |
| Samaritan Ministries International | $1,890 - $3,774 | 775% |
| Medincrease Health Plan | $1,890 - $3,774 | 775% |
| Prime Health Services | $2,180 - $4,355 | 894% |
| UnitedHealthcare | $2,616 - $5,225 | 1073% |
| Cigna | $2,762 - $5,516 | 1133% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at Nmc Health in Newton, Kansas, the cash price is $2,090, which is lower than the facility's gross charge of $2,986. While the facility's negotiated rates with major insurers like UnitedHealthcare and Cigna range from $2,616 to $5,516, these amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the insurance negotiated rates can sometimes exceed the cash price. To secure the lowest possible cost, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the bill by 20% to 50% if paid in full upfront.
When reviewing your bill, be aware that commercial rates are frequently compared against the Medicare benchmark of $243.77, which serves as the objective baseline for true healthcare costs. Although the data indicates a 8.9% variance versus Medicare, this metric highlights that commercial rates are significantly marked up compared to the federal government's fixed reimbursement. It is important to avoid using the hospital's full chargemaster list as a benchmark, as these inflated prices are designed to make discounts appear larger than they are. If you receive a summary bill, request a detailed, itemized statement to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.