CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Graham County Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $601
  • Cash Discount Price: $775
  • vs. Medicare Baseline: 2.47x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Graham County Hospital is $601. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $775. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.47x the Medicare baseline. Located in 304 West Prout Street, Hill City, KS.
Cash / Self-Pay
$775

Average discount available for prompt cash payment at this facility.

Insurance Median
$601

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: $775 (318%)
Insurance Median: $601 (247%)
Cash: $775 (318% of Medicare)
Ins. Median: $601 (247% 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 247% of the Medicare baseline (a markup of 147%). 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
UnitedHealthcare $374 - $736 153%
Medicaid / KanCare $374 153%
Blue Cross Blue Shield $521 214%
Medicare (plans) $581 238%
Celtic Commercial-All Other Plans $639 262%
Wppa (Providers Care)-All Plans $736 302%

Consumer Guidance & Cost Commentary

For the MRI of a knee or other leg joint at Graham County Hospital in Hill City, Kansas, the cash price is $775.00, which matches the facility's median paid amount. This cash rate is notably higher than the state average for this procedure, which is $639.00. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans might find that paying the full cash price upfront is more cost-effective than using insurance, as the negotiated rates for major payers like UnitedHealthcare and Celtic Commercial range from $521 to $736. Because the cash price is already at the facility's median paid level, there is no significant gap between self-pay and insurance reimbursement for this specific service, but it remains above the state average.

To minimize potential costs, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these programs can offer immediate fee reductions for upfront payment. It is also important to request a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Furthermore, if you receive a balance bill for out-of-network ancillary services, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. Always verify your deductible status and request a formal written audit dispute if you believe any charges are incorrect.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 304 West Prout Street, Hill City, KS 67642
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals