CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Medicine Lodge Memorial Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $647
  • Cash Discount Price: $687
  • vs. Medicare Baseline: 2.65x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Medicine Lodge Memorial Hospital is $647. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $687. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.65x the Medicare baseline. Located in 710 N Walnut Street, Medicine Lodge, KS.
Cash / Self-Pay
$687

Average discount available for prompt cash payment at this facility.

Insurance Median
$647

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: $687 (282%)
Insurance Median: $647 (265%)
Cash: $687 (282% of Medicare)
Ins. Median: $647 (265% 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 265% of the Medicare baseline (a markup of 165%). 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 $518 - $583 212%
Humana $589 - $662 242%
Aetna $598 - $727 245%
Hpk-All Plans $615 - $691 252%
UnitedHealthcare $615 - $691 252%
Medicaid / KanCare $647 - $727 265%

Consumer Guidance & Cost Commentary

For the MRI procedure of the knee or other leg joint at Medicine Lodge Memorial Hospital in Medicine Lodge, Kansas, the cash price is $687.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average for this service, as indicated by the 2.7x multiplier relative to the Medicare benchmark of $243.77. While commercial insurance plans like Tricare, Humana, and Aetna negotiate rates ranging from $518 to $727, these negotiated amounts often exceed the cash price. Patients with high-deductible plans or those without immediate insurance coverage may find paying the cash rate directly more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the negotiated allowed amount surpasses the cash price.

To minimize potential financial surprises, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% for upfront payment. It is also important to request a full itemized bill before finalizing payment, as summary invoices often obscure individual charges and may include unbundled codes or services not rendered. Under federal protections like the No Surprises Act, patients are generally shielded from balance billing for emergency care or non-emergency services at in-network facilities, though disputes regarding unexpected charges should be handled in writing to ensure rights are preserved.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 710 N Walnut Street, Medicine Lodge, KS 67104
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals