MRI, knee or other leg joint
Facility: Sheridan County Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $761
- Cash Discount Price: $1,049
- vs. Medicare Baseline: 3.12x 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 312% of the Medicare baseline (a markup of 212%). 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 Insurance | $635 | 260% |
| Blue Cross Blue Shield | $761 | 312% |
| UnitedHealthcare | $997 | 409% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at Sheridan County Hospital in Hoxie, Kansas, the cash price is $1,049.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average, which is 3.1 times the Medicare benchmark of $243.77. While commercial insurance plans like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare have negotiated rates of $635, $761, and $997 respectively, these amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying cash upfront can be the most cost-effective option, provided you confirm with the hospital that they offer a "self-pay" or "prompt-pay" discount to avoid balance billing or administrative fees.
Patients should be aware that commercial negotiated rates frequently include administrative overhead, making them higher than the true cost of care represented by Medicare benchmarks. To ensure you are not overpaying, always request a full itemized bill before settling any debt, as summary invoices may hide unbundled charges or services not rendered. If you receive a bill that seems unusually high, dispute it in writing with the billing supervisor rather than accepting the amount immediately, and verify that your insurance has not submitted a claim that voids any potential cash discount.