MRI, knee or other leg joint
Facility: Phillips County Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $742
- Cash Discount Price: $697
- vs. Medicare Baseline: 3.04x 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 304% of the Medicare baseline (a markup of 204%). 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 | $553 - $664 | 227% |
| UnitedHealthcare | $656 - $820 | 269% |
| Health Partners-All Plans | $820 | 336% |
| Medicaid / KanCare | $820 | 336% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at Phillips County Hospital in Phillipsburg, Kansas, the facility's cash median price is $697.00, which is lower than the negotiated rates paid by major insurers like UnitedHealthcare ($656 to $820) and Blue Cross Blue Shield ($553 to $664). While the cash price is generally lower than the insurance negotiated rates, patients with high-deductible plans should consider that paying out-of-pocket might save money if their insurance allowed amount exceeds the cash price. It is important to note that the facility's cash rate is significantly higher than the Medicare benchmark of $243.77, indicating a markup typical of commercial pricing structures where rates often average 200% to 300% of the Medicare base.
To ensure you are not overcharged, you should request a full itemized billing audit before paying, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing the administrative costs associated with insurance claims processing. If you receive a surprise balance bill from an out-of-network provider, remember that the No Surprises Act protects you from paying the difference between the provider's full chargemaster rate and your insurance allowed amount for emergency care and non-emergency services at in-network facilities.