CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Rooks County Health Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,812
  • Cash Discount Price: $1,510
  • vs. Medicare Baseline: 7.43x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Rooks County Health Center is $1,812. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,510. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.43x the Medicare baseline. Located in 1210 North Washington, Plainville, KS.
Cash / Self-Pay
$1,510

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,812

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: $1,510 (619%)
Insurance Median: $1,812 (743%)
Cash: $1,510 (619% of Medicare)
Ins. Median: $1,812 (743% 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 743% of the Medicare baseline (a markup of 643%). 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
Blue Cross Blue Shield $553 227%
Veterans Admin - All Plans $946 388%
Celtic Mcr Adv $946 388%
Tricare $946 388%
Celtic Comm - All Other Plans $1,041 427%
UnitedHealthcare $1,812 743%
Aetna $1,812 743%
Preferred Benefits Admin $1,812 743%
Preferred Hlthcare - All Other Plans $1,913 785%
Health Partners - All Plans $1,913 785%
Healthy Blue Mcaid - All Plans $2,014 826%

Consumer Guidance & Cost Commentary

For the MRI of a knee or other leg joint at Rooks County Health Center in Plainville, Kansas, the facility's cash price is $1,510, which is lower than the negotiated rates charged to most insurance plans. While the facility's cash rate is higher than the state average for this procedure, it remains significantly lower than the typical negotiated amounts seen with major payers like UnitedHealthcare, Aetna, and Preferred Benefits Admin, which all list rates of $1,812 or higher. Because commercial insurance contracts often include administrative overhead and multi-layered pricing structures, patients with high-deductible plans may find paying the cash price directly more affordable than having insurance cover the service, especially if their deductible has not yet been met.

To ensure you receive the most accurate pricing, it is important to request an itemized billing audit before finalizing payment, as summary bills can obscure individual charges or unbundled codes that should be consolidated. Additionally, since this facility is a Critical Access Hospital owned by a Government Hospital District, you should explicitly ask about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. While the Medicare benchmark for this service is $243.77, commercial rates are naturally higher due to provider costs and risk adjustments; however, comparing your specific plan's allowed amount to the cash price can reveal significant savings if you choose to pay out-of-pocket.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1210 North Washington, Plainville, KS 67663
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals