MRI, knee or other leg joint
Facility: Lmh
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $477
- Cash Discount Price: $1,679
- vs. Medicare Baseline: 1.96x 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 |
|---|---|---|
| Medicare (plans) | $90 - $530 | 37% |
| UnitedHealthcare | $90 - $5,947 | 37% |
| Humana | $90 - $530 | 37% |
| Cigna | $90 - $5,983 | 37% |
| Blue Cross Blue Shield | $105 - $5,795 | 43% |
| Haskell Indian Health Services | $105 - $530 | 43% |
| Allwell | $107 - $541 | 44% |
| Ambetter / Centene | $107 - $822 | 44% |
| Aetna | $1,721 - $7,434 | 706% |
| Non Contracted | $3,583 - $7,166 | 1470% |
| First Health | $4,165 - $8,330 | 1709% |
Consumer Guidance & Cost Commentary
For this MRI procedure at Lmh in Lawrence, KS, the cash price of $1,679 is significantly lower than the facility's gross charge of $6,718 and the Medicare benchmark of $243.77. While commercial insurance plans like UnitedHealthcare and Cigna have negotiated rates ranging from $90 to nearly $6,000, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance allowed amount exceeds the cash price. It is important to note that while the facility is in-network for many carriers, the actual amount paid by insurance varies widely; for instance, some plans may only allow $90, whereas others allow up to $8,330. Patients should verify their specific plan's allowed amount before scheduling to ensure they are not paying more than necessary.
To minimize unexpected costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, if you receive a bill from an out-of-network provider or for services like emergency care at an in-network facility, you may be protected by the No Surprises Act, which bans balance billing for these scenarios. If you do receive a surprise bill, do not pay immediately; instead, request a formal itemized audit to identify errors such as unbundled codes or services not rendered, as over 80% of hospital bills contain mistakes. Always dispute any balance billing in writing and request a No Surprises Act audit to protect your financial interests.