MRI, knee or other leg joint
Facility: Great Plains Of Sabetha
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $1,223
- Cash Discount Price: $1,276
- vs. Medicare Baseline: 5.02x 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 502% of the Medicare baseline (a markup of 402%). 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 |
|---|---|---|
| Celtic Mcr Adv | $651 - $677 | 267% |
| Aetna | $657 - $1,314 | 270% |
| Celtic Comm Exchange-All Other Plans | $813 - $846 | 334% |
| Great West Healthcare-All Plans | $1,064 - $1,106 | 436% |
| UnitedHealthcare | $1,164 - $1,301 | 477% |
| Cigna | $1,189 - $1,236 | 488% |
| Century/Wppa/Providers-All Plans | $1,189 - $1,236 | 488% |
| Humana | $1,189 - $1,236 | 488% |
| Multiplan-Phcs-All Plans | $1,189 - $1,236 | 488% |
| Federated Mutual Ins-All Plans | $1,201 - $1,249 | 493% |
| Blue Cross Blue Shield | $1,251 - $1,301 | 513% |
| Medicaid / KanCare | $1,251 - $1,301 | 513% |
Consumer Guidance & Cost Commentary
For the MRI of the knee or other leg joint at Great Plains of Sabetha, the cash median price is $1,276.00, which matches the facility's negotiated median rate of $1,223.00. This cash price is notably higher than the state average for this procedure, suggesting that paying out-of-pocket may not be the most cost-effective option for patients with high-deductible plans. While commercial payers like Aetna and UnitedHealthcare have negotiated rates ranging from $657 to $1,314, these figures often exceed the cash price due to administrative overhead and contract structures. Patients should verify their specific plan's deductible status before scheduling, as paying the cash rate upfront could result in immediate savings if the insurance allowed amount is higher than the cash price.
To ensure you are receiving the most accurate pricing, it is important to request a full itemized bill rather than accepting a summary invoice, as hospitals may obscure individual costs under broad categories. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if you settle the bill in full within 30 days. This facility, a voluntary non-profit Critical Access Hospital in Sabetha, KS, has a Medicare benchmark of $243.77, indicating that commercial rates are significantly marked up compared to the federal baseline. If you encounter unexpected charges, dispute them in writing to avoid balance billing, especially since the No Surprises Act protects patients from being billed for out-of-network services at in-network facilities.