CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Hamilton County Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,166
  • Cash Discount Price: $1,296
  • vs. Medicare Baseline: 4.78x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Hamilton County Hospital is $1,166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,296. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.78x the Medicare baseline. Located in 700 North Huser Street, Syracuse, KS.
Cash / Self-Pay
$1,296

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,166

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: $1,296 (532%)
Insurance Median: $1,166 (478%)
Cash: $1,296 (532% of Medicare)
Ins. Median: $1,166 (478% 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 478% of the Medicare baseline (a markup of 378%). 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 $247 - $553 101%
First Health Coventry - All Plans $1,102 452%
Cigna $1,231 505%
UnitedHealthcare $1,231 505%
Va Ccn - All Plans $1,296 532%
Aetna $2,203 904%

Consumer Guidance & Cost Commentary

For the MRI of a knee or other leg joint at Hamilton County Hospital in Syracuse, KS, the cash price is $1,296.00, which matches the facility's cash median. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates vary significantly among payers; for instance, First Health Coventry and Cigna each have a fixed negotiated rate of $1,102 and $1,231 respectively, whereas Aetna's negotiated rate is $2,203. Because commercial negotiated rates often include administrative overhead and can exceed the cash price, patients with high-deductible plans may find it financially advantageous to pay the cash price directly, provided they confirm the facility offers a "self-pay" or "prompt-pay" discount for upfront payment.

The Medicare benchmark for this service is $243.77, which serves as a baseline to evaluate the facility's pricing markup. The facility's cash rate of $1,296.00 represents a 4.8x multiplier compared to the Medicare amount, reflecting the standard administrative and operational costs associated with commercial billing. To ensure you are not overcharged, it is recommended to request a full itemized bill before finalizing payment, as summary bills often obscure individual charges. If you receive a balance bill for an out-of-network service, you may be entitled to protections under the No Surprises Act, and you should dispute any unexpected charges in writing rather than accepting them immediately.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 700 North Huser Street, Syracuse, KS 67878
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals