MRI, knee or other leg joint
Facility: Mcpherson Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $2,049
- Cash Discount Price: $2,166
- vs. Medicare Baseline: 8.41x 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 841% of the Medicare baseline (a markup of 741%). 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 |
|---|---|---|
| UnitedHealthcare | $51 - $3,495 | 21% |
| Tricare | $53 - $193 | 22% |
| Blue Cross Blue Shield | $60 - $219 | 25% |
| Wellcare Mcr Adv - All Plans | $60 - $219 | 25% |
| Healthy Blue Mcr Adv | $60 - $219 | 25% |
| Aetna | $60 - $3,495 | 25% |
| Humana | $60 - $219 | 25% |
| Va Ccn - All Plans | $60 - $219 | 25% |
| Ambetter / Centene | $60 - $252 | 25% |
| Multiplan - All Plans | $74 - $3,146 | 30% |
| Medicaid / KanCare | $197 - $3,495 | 81% |
| Health Blue Mcaid - All Other Plans | $201 - $3,565 | 82% |
| Medical Associates - All Plans | $430 - $2,621 | 176% |
| Central Plains - All Plans | $430 - $2,621 | 176% |
| Cigna | $544 - $3,320 | 223% |
| Health Partners - All Plans | $544 - $3,320 | 223% |
| Wppa - All Plans | $2,049 - $2,446 | 841% |
| Christian Health Aid - All Plans | $2,342 - $2,796 | 961% |
| First Health - All Plans | $2,781 - $3,320 | 1141% |
Consumer Guidance & Cost Commentary
For the MRI procedure of the knee or other leg joint at McPherson Hospital in Mcpherson, Kansas, the cash median price is $2,166.00, while the median amount paid by insurance is $2,283.00. This indicates that for patients with high-deductible plans, paying cash upfront may be more cost-effective than using insurance, as the negotiated rates from payers like UnitedHealthcare and Aetna can exceed the cash price. Although the facility's negotiated rate of $2,049.00 is lower than the cash median, it is important to verify your specific plan's deductible status before scheduling, as paying out-of-pocket might result in a lower total out-of-pocket cost if your insurance has not yet covered the service.
When evaluating costs, it is crucial to compare rates against the Medicare benchmark rather than the hospital's gross charges, as the latter can be inflated to make discounts appear larger. The Medicare amount for this service is $243.77, which serves as the objective baseline for fair pricing; commercial negotiated rates typically range from 200% to 300% of this figure, though fair pricing is often defined as 120% to 150%. Additionally, patients should be aware of the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, and should request a formal itemized audit if they receive a summary bill that obscures individual line items or unbundled codes.