CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mercy Specialty Hospital Southeast Kansas

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,373
  • Cash Discount Price: $1,722
  • vs. Medicare Baseline: 5.63x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mercy Specialty Hospital Southeast Kansas is $1,373. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,722. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.63x the Medicare baseline. Located in 1619 K 66, Galena, KS.
Cash / Self-Pay
$1,722

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,373

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%)
Cash / Self-Pay: $1,722 (706%)
Insurance Median: $1,373 (563%)
Cash: $1,722 (706% of Medicare)
Ins. Median: $1,373 (563% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 563% of the Medicare baseline (a markup of 463%). 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.

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
Medicaid / KanCare $120 - $380 49%
Aetna $120 - $231 49%
Humana $120 - $235 49%
Provider Partners Health Plans Contracted [320450] $129 53%
Blue Cross Blue Shield $131 - $564 54%
First Health Contracted [320128] $198 81%
UnitedHealthcare $206 - $3,086 85%
Elara Caring Aspire Hospice [20433] $231 95%
Mercy Mgd Behavioral Health Contracted [320259] $231 95%
Qual Choice Contracted [320325] $231 95%
Globalhealth Contracted [320145] $231 95%
Medical Associates Health Contracted [320444] $231 95%
Cigna $231 - $935 95%
Kindful Hospice Contracted [320434] $231 95%
Pace Of The Ozarks Contracted [320518] $231 95%
Halo Hcr Inc Hospice Contracted [320432] $231 95%
Cross Timbers Hospice [20098] $231 95%
Halo Hcr Inc Hospice [20432] $231 95%
Mercy Hospice Okc [20252] $231 95%
Medicare (plans) $231 95%
Kindful Hospice [20434] $231 95%
Cherokee Nation Health Serv Contracted [320066] $231 95%
Tricare $231 95%
Centivo Contracted [320505] $235 96%
Dept Of Veteran Affairs Contracted [320106] $235 96%
United Medical Resources Contracted [320454] $276 - $629 113%
Providrs Care Network Contracted [320484] $447 183%
Point C Contracted [320238] $629 - $2,502 258%
Health Systems Inc Contracted [320174] $629 258%
Insurance System Inc Contracted [320465] $629 258%
Healthscope Contracted [320182] $629 - $2,502 258%
Benefit Management Contracted [320052] $629 258%
Medica Contracted [320239] $1,101 452%
Mercy Benefit Admin Contracted [320251] $1,313 - $2,335 539%
Show-Me Health Administrators Contracted [320483] $1,313 539%
Aither Health Contracted [320449] $1,373 - $2,335 563%
Imagine 360 Contracted [320494] $1,373 - $2,335 563%
Ebms Contracted [320493] $1,373 - $2,335 563%
Yuzu Health Contracted [320521] $1,373 - $2,335 563%
Edison Health Solutions Contracted [320502] $1,373 - $2,335 563%
American Healthcare Alliance Contracted [320020] $1,373 - $2,335 563%
Reflect Health Contracted [320492] $1,373 - $2,335 563%
Auxiant Contracted [320462] $1,373 - $2,502 563%
Preferred Health Plan Contracted [320522] $1,472 - $2,502 604%
Federal Medical Center Contracted [320127] $1,472 - $2,502 604%
Healthlink Contracted [320179] $1,472 - $2,502 604%
Compcare Of The Ozarks Contracted [320437] $1,550 - $2,635 636%
Workers Comp [20426] $1,570 - $2,669 644%
Private Health Care Systems Contracted [320320] $1,815 - $3,086 745%
Multiplan Contracted [320270] $1,864 - $3,169 765%
Multiplan [20270] $1,864 - $3,169 765%

Consumer Guidance & Cost Commentary

For the MRI of a knee or other leg joint at Mercy Specialty Hospital Southeast Kansas, the facility's cash price of $1,722 is significantly lower than the median negotiated rate of $1,373 paid by most commercial insurers, including UnitedHealthcare and Cigna. While many payers have negotiated rates ranging from $120 to over $2,500, the cash price offers a substantial discount for patients who pay upfront, particularly those with high-deductible plans where insurance reimbursement might still exceed the cash amount. Because hospitals often offer prompt-pay discounts of 20% to 50% for immediate payment, patients should explicitly ask for self-pay rates and waive insurance submission before scheduling to ensure they receive the lowest possible price.

The facility's cash rate is also notably lower than the Medicare benchmark of $243.77, which serves as the objective baseline for fair pricing in healthcare. Although commercial negotiated rates are often higher than Medicare due to administrative costs and contract structures, the cash price here remains competitive and well below the gross charge of $2,649. To avoid unexpected balance billing or errors, patients should request a full itemized bill before paying, as summary invoices can obscure individual charges. If a patient receives a bill that exceeds the cash price or Medicare rate, they should dispute it in writing with the billing supervisor rather than accepting the amount immediately.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1619 K 66, Galena, KS 66739
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals