MRI, knee or other leg joint
Facility: Ellinwood District Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $476
- Cash Discount Price: $578
- vs. Medicare Baseline: 1.95x 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 |
|---|---|---|
| Aetna | $476 | 195% |
| Blue Cross Blue Shield | $476 | 195% |
| Humana | $476 | 195% |
| UnitedHealthcare | $476 | 195% |
| Cigna | $476 | 195% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at Ellinwood District Hospital in Ellinwood, KS, the cash median price is $578.00, which is lower than the negotiated rates of $476.00 paid by major insurers like Aetna, Blue Cross Blue Shield, Humana, UnitedHealthcare, and Cigna. This facility, a Critical Access Hospital owned by the Government Hospital District, has a single plan with each of these five payers, all negotiating the same rate. Because the cash price is higher than the negotiated rate, patients with high-deductible plans may find it beneficial to pay the cash price directly, as the insurance negotiated rate of $476.00 is already below the cash amount. However, patients should verify with the hospital for potential "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can sometimes reduce the final cost further.
The Medicare benchmark for this service is $243.77, which serves as a baseline for evaluating the facility's pricing markup. While the data does not provide specific state or county average comparisons for this code, the facility's negotiated rate of $476.00 represents the contractual ceiling for in-network members. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still request an itemized billing audit if they receive a summary bill, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. Disputing these errors in writing is the most effective way to reduce medical debt, ensuring that only services actually rendered are charged