MRI, knee or other leg joint
Facility: Hospital District #6 Patterson Health Center
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $810
- Cash Discount Price: $720
- vs. Medicare Baseline: 3.32x 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 332% of the Medicare baseline (a markup of 232%). 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 | $495 - $521 | 203% |
| UnitedHealthcare | $810 - $900 | 332% |
| Providers Care (Wppa)-All Plans | $1,575 | 646% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at the Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash median price is $720.00, which is lower than the median negotiated rate of $810.00 paid by UnitedHealthcare. While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans might find the cash price more beneficial if their insurance negotiated rate exceeds this amount. It is important to note that while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, patients should still verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not charged the full chargemaster rate.
The Medicare benchmark for this service is $243.77, which serves as a baseline for evaluating the facility's pricing markup. Although the provided data does not include specific state or county average comparisons for this procedure, the significant difference between the Medicare rate and the cash price highlights the potential for substantial savings when paying out-of-pocket. To avoid unexpected costs, patients should request a full itemized bill containing specific CPT codes rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled charges or services not rendered. If a balance bill or unexpected charge arises, patients should dispute it in writing with the billing supervisor rather than paying immediately, and they should refuse to sign out-of-network cost waivers for mandatory services to protect their rights.