MRI, knee or other leg joint
Facility: Lane County Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $875
- Cash Discount Price: $875
- vs. Medicare Baseline: 3.59x 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 359% of the Medicare baseline (a markup of 259%). 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 |
|---|---|---|
| Aetna | $788 - $831 | 323% |
| UnitedHealthcare | $788 - $875 | 323% |
| Healthy Blue Mcaid | $875 | 359% |
| Medicaid / KanCare | $875 - $962 | 359% |
| Healthy Blue Mcr Adv - All Other Plans | $875 | 359% |
| Wppa Providers-All Plans | $1,312 | 538% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at Lane County Hospital in Dighton, Kansas, the cash and median negotiated rates are both $875.00, which matches the gross charge listed for this CPT code. This facility, a Critical Access Hospital owned by a Government Hospital District, does not offer a lower self-pay or prompt-pay discount in the provided data, meaning patients with high-deductible plans may find paying cash upfront to be the most cost-effective option compared to using insurance, which often results in higher allowed amounts due to administrative overhead. While the facility's rates align with the specific code's standard pricing, patients should verify if their specific insurance plan has a lower allowed amount by contacting the hospital directly before scheduling, as commercial negotiated rates can sometimes exceed the cash price depending on the payer contract.
The Medicare benchmark for this procedure is $243.77, indicating that the facility's standard rates represent a significant markup above the federal government's cost-based reimbursement. Although the data does not provide explicit county or state average comparisons for this specific code, the substantial difference between the Medicare rate and the facility's cash price highlights the typical administrative and contractual layers inherent in commercial billing. To ensure you are not overpaying, it is advisable to request an itemized billing audit if you receive a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or charges for services not rendered. Additionally, under the No Surprises Act, you are protected from balance billing for out-of-network providers at in-network facilities, so you should dispute any unexpected bills and request a formal audit rather than paying immediately out of fear.