MRI, knee or other leg joint
Facility: Ellsworth County Medical Center
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $778
- Cash Discount Price: $864
- vs. Medicare Baseline: 3.19x 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 319% of the Medicare baseline (a markup of 219%). 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 |
|---|---|---|
| Healthy Blue Mcr Adv | $406 | 167% |
| Triwest -All Plans | $406 | 167% |
| Va Ccn-All Plans | $406 | 167% |
| Humana | $406 - $821 | 167% |
| Blue Cross Blue Shield | $495 - $521 | 203% |
| UnitedHealthcare | $562 - $864 | 231% |
| First Health - All Plans | $778 | 319% |
| Aetna | $778 | 319% |
| Cigna | $821 | 337% |
| Coventry Mcaid-All Plans | $864 | 354% |
| Medicaid / KanCare | $864 | 354% |
| Healthy Blue Mcaid- All Other Plans | $864 | 354% |
| Providers Care-Wppa-All Plans | $1,296 | 532% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at Ellsworth County Medical Center in Ellsworth, Kansas, the cash median price is $864.00, which matches the facility's gross charge and the Medicare amount of $243.77 adjusted for the local market. While the facility is a Critical Access Hospital with a proprietary ownership structure, patients should be aware that commercial negotiated rates vary significantly; for instance, UnitedHealthcare plans may pay up to $864, whereas Healthy Blue Mcr Adv and Triwest -All Plans pay a flat $406. This variation highlights that in-network status does not guarantee the lowest possible price, as some payers negotiate rates well below the cash price. Consumers with high-deductible plans might find it financially advantageous to pay the cash median of $864.00 directly, as this could be cheaper than the negotiated rates some insurers apply, which often include administrative overheads that inflate the baseline price by 20% to 40%.
To ensure you are receiving the most accurate pricing, it is crucial to request an itemized billing audit before finalizing payment, as summary bills often obscure individual code costs and may include unbundled charges or services not rendered. While the facility's median negotiated rate is $778.00, which is lower than the cash price, patients must verify their specific plan's allowed amount and deductible status to avoid unexpected out-of-pocket costs. Additionally, asking about prompt-pay discounts before scheduling can result in a fee reduction of 20% to 50% if you pay in full upfront, bypassing the costly claims processing cycle that insurance billing entails. Given that over 80%