MRI, knee or other leg joint
Facility: Ashland Health Center
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $767
- Cash Discount Price: $614
- vs. Medicare Baseline: 3.15x 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 315% of the Medicare baseline (a markup of 215%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $257 | 105% |
| Compalliance-All Plans | $614 | 252% |
| Health Partners Of Kansas-All Plans | $652 | 267% |
| Multiplan-All Plans | $752 | 308% |
| Healthy Blue Mcr Adv - All Other Plans | $767 | 315% |
| UnitedHealthcare | $767 | 315% |
| Medica Mcare - All Plans | $767 | 315% |
| Health Choice-All Plans | $767 | 315% |
| Medicare (plans) | $767 | 315% |
| Aetna | $767 | 315% |
| Medicaid / KanCare | $767 | 315% |
| Providers Care (Wppa)-All Plans | $1,150 | 472% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at Ashland Health Center in Ashland, KS, the facility's cash price is $614.00, which is lower than the negotiated rates of $767.00 paid by most insurance plans, including UnitedHealthcare, Aetna, and Medicare. While commercial payers like Blue Cross Blue Shield and Compalliance-All Plans also pay $257 and $614 respectively, the cash rate remains the most affordable option for self-pay patients. It is important to note that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $614.00 upfront can be significantly cheaper than the $767.00 negotiated rate that their insurance would otherwise apply, effectively bypassing administrative fees and claim processing costs.
The facility's pricing is benchmarked against the Medicare rate of $243.77, which serves as the federal baseline for healthcare costs. Although the data does not provide specific state or county average comparisons for this procedure, the facility's cash rate of $614.00 represents a substantial markup over the Medicare amount, reflecting the typical administrative overhead and contract dynamics of the healthcare system. Patients should be aware that while the facility is a Critical Access Hospital owned by a voluntary non-profit, the final amount owed depends heavily on whether you are paying out-of-pocket or utilizing insurance. To ensure you receive the best possible rate, it is recommended to explicitly request a "self-pay" or "prompt-pay" discount before scheduling your appointment, as these upfront payment incentives can further reduce the total cost.