MRI, knee or other leg joint
Facility: Cheyenne County Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $793
- Cash Discount Price: $710
- vs. Medicare Baseline: 3.25x 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 325% of the Medicare baseline (a markup of 225%). 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 |
|---|---|---|
| UnitedHealthcare | $479 - $835 | 196% |
| Blue Cross Blue Shield | $521 | 214% |
| First Health - All Plans | $584 | 240% |
| Healthy Blue Mcr Adv | $601 | 247% |
| Tricare | $601 | 247% |
| Aetna | $601 - $793 | 247% |
| Choice Care - All Plans | $607 | 249% |
| Firstguard - All Plans | $668 | 274% |
| Wppa - All Plans | $752 | 308% |
| Preferred Hc - All Plans | $793 | 325% |
| Cpm - All Plans | $793 | 325% |
| Midlands Choice - All Plans | $810 | 332% |
| Ppo Next - All Plans | $818 | 336% |
| Health Partners - All Plans | $818 | 336% |
| Unicare - All Plans | $818 | 336% |
| Integrated Hp - All Plans | $818 | 336% |
| Healthy Blue Mcaid - All Other Plans | $835 | 343% |
| Childrens Mercy - All Plans | $835 | 343% |
| Healthwave Mcaid - All Plans | $835 | 343% |
| Providers Care-All Plans | $1,252 | 514% |
Consumer Guidance & Cost Commentary
For CPT code 73721, representing an MRI of the knee or other leg joint, the gross charge at Cheyenne County Hospital is $835.00. While the facility's cash median price is $710.00, the negotiated rates paid by insurance plans range from $479 to $1,252, with a median negotiated amount of $793.00. It is important to note that for patients with high-deductible plans, paying the cash price of $710.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash price. Additionally, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed before any insurance claim is processed.
This procedure is performed at a Critical Access Hospital in St Francis, KS, and the facility's pricing is benchmarked against federal standards. The Medicare amount for this service is $243.77, which serves as the objective baseline for evaluating commercial pricing markups. Commercial negotiated rates typically average 200% to 300% of the Medicare rate, whereas fair pricing is generally defined as 120% to 150% of this benchmark. If you receive a bill, you should request a detailed, itemized statement to verify that no services were unbundled or that charges for items not rendered were included, as over 80% of hospital bills contain errors. Furthermore, if you are an out-of-network patient receiving care at an in-network facility, the No Surprises Act protects you from balance billing for emergency