CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Cloud County Health Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $3,721
  • Cash Discount Price: $2,742
  • vs. Medicare Baseline: 15.26x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Cloud County Health Center is $3,721. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,742. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 15.26x the Medicare baseline. Located in 155 West College Drive, Concordia, KS.
Cash / Self-Pay
$2,742

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,721

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: $2,742 (1125%)
Insurance Median: $3,721 (1526%)
Cash: $2,742 (1125% of Medicare)
Ins. Median: $3,721 (1526% 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 1526% of the Medicare baseline (a markup of 1426%). 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
Aetna $3,525 - $3,643 1446%
Pponext-All Plans $3,721 1526%
Mpi-All Plans $3,721 1526%
Health Partners - All Plans $3,721 1526%

Consumer Guidance & Cost Commentary

For the MRI of a knee or other leg joint at Cloud County Health Center in Concordia, KS, the facility's cash median price is $2,742, which is lower than the negotiated rates of $3,721 paid by major payers like Aetna, Pponext-All Plans, and MPI-All Plans. While commercial insurance contracts often result in higher out-of-pocket costs for patients with high deductibles, the cash price remains the most affordable option for those paying directly. It is important to note that this facility is a Critical Access Hospital with a voluntary non-profit ownership structure, and patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not charged the full negotiated amount.

When evaluating the cost of this procedure, it is crucial to compare rates against the Medicare benchmark rather than the hospital's gross charges. The Medicare amount for this code is $243.77, and the facility's cash rate of $2,742 represents a significant markup above this federal baseline. Although the data does not provide specific state or county average comparisons for this procedure, patients should be aware that commercial negotiated rates often exceed fair pricing benchmarks, which are typically defined as 120% to 150% of the Medicare rate. To avoid unexpected costs, consumers should request an itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 155 West College Drive, Concordia, KS 66901
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals