CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Kiowa District Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $898
  • Cash Discount Price: $760
  • vs. Medicare Baseline: 3.68x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Kiowa District Hospital is $898. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $760. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.68x the Medicare baseline. Located in 1002 South 4Th Street, Kiowa, KS.
Cash / Self-Pay
$760

Average discount available for prompt cash payment at this facility.

Insurance Median
$898

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: $760 (312%)
Insurance Median: $898 (368%)
Cash: $760 (312% of Medicare)
Ins. Median: $898 (368% 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 368% of the Medicare baseline (a markup of 268%). 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
Tricare $370 152%
Healthchoice-All Plans $466 191%
Blue Cross Blue Shield $521 214%
UnitedHealthcare $760 - $950 312%
Health Partners Of Ks-All Plans $836 343%
Humana $857 352%
Gbs Insurance - All Plans $893 366%
Multiplan-All Plans $893 366%
Medicare (plans) $902 370%
Triwest-All Plans $902 370%
Aetna $902 370%
Medicaid / KanCare $950 390%
Providers Care (Wppa)-All Plans $1,425 585%
Liberty Healthshare-All Plans $1,534 629%

Consumer Guidance & Cost Commentary

For the MRI of a knee or other leg joint at Kiowa District Hospital in Kiowa, KS, the cash price is $760, which is lower than the facility's negotiated rates with most major payers. While the hospital is a Critical Access Hospital owned by the Government - Hospital District or Authority, patients should be aware that insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. For instance, UnitedHealthcare's range spans from $760 to $950, and Medicaid/KanCare is set at $950, meaning paying cash upfront could result in immediate savings compared to standard insurance billing. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these incentives can further reduce the final amount owed.

The facility's pricing is significantly higher than the Medicare benchmark of $243.77, which serves as the objective baseline for healthcare costs in this region. Although the data does not provide specific state or county average comparisons for this procedure, the substantial markup from the Medicare rate highlights the importance of understanding commercial pricing dynamics. Patients should avoid accepting summary bills and instead request a detailed, itemized CPT-coded statement to identify any errors or unbundled charges, as over 80% of hospital bills contain inaccuracies. If a balance bill arises from out-of-network services, the No Surprises Act may protect patients from paying the difference between the negotiated rate and the full chargemaster, so disputing unexpected bills with the insurer is a critical step to prevent financial harm.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1002 South 4Th Street, Kiowa, KS 67070
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals