MRI, knee or other leg joint
Facility: Clara Barton Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $1,612
- Cash Discount Price: $1,533
- vs. Medicare Baseline: 6.61x 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 661% of the Medicare baseline (a markup of 561%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $521 | 214% |
| 6 Degrees Health - All Plans | $1,226 - $1,840 | 503% |
| Wppa-All Plans | $1,402 - $2,103 | 575% |
| Phcs - All Plans | $1,577 - $2,366 | 647% |
| Aetna | $1,577 - $2,366 | 647% |
| UnitedHealthcare | $1,577 - $2,366 | 647% |
| Hlth Partners Of Ks-All Plans | $1,612 - $2,419 | 661% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at Clara Barton Hospital in Hoisington, KS, the cash median price is $1,533, which is lower than the facility's negotiated rates of $1,612 and the median paid amount of $1,726. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. If you have a high-deductible plan, paying the cash price of $1,533 upfront might result in lower out-of-pocket costs compared to your insurance allowing a higher negotiated rate, provided you have met your deductible. It is advisable to explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these can further reduce the final bill by bypassing costly insurance billing cycles.
When evaluating this price against federal benchmarks, the Medicare amount for this procedure is $243.77. The facility's cash rate of $1,533 represents a significant markup relative to the Medicare baseline, which serves as the objective cost standard for healthcare delivery. While commercial rates typically average between 200% and 300% of Medicare, fair pricing is generally defined as 120% to 150% of the Medicare rate. To ensure you are receiving the most accurate pricing, always request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive a balance bill from an out-of-network provider, you may be entitled to protections under