MRI, knee or other leg joint
Facility: Trego County Lemke Memorial Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $756
- Cash Discount Price: $786
- vs. Medicare Baseline: 3.10x 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 310% of the Medicare baseline (a markup of 210%). 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 |
|---|---|---|
| Humana | $453 | 186% |
| Tricare | $489 | 201% |
| Aetna | $574 - $832 | 235% |
| Va Ccn - All Plans | $574 | 235% |
| UnitedHealthcare | $574 - $925 | 235% |
| Medicaid / KanCare | $574 - $925 | 235% |
| Ambetter / Centene | $631 | 259% |
| Blue Cross Blue Shield | $756 | 310% |
| Health Partners - All Plans | $879 | 361% |
| Healthy Blue Mcaid - All Plans | $925 | 379% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at Trego County Lemke Memorial Hospital in Wakeeney, KS, the cash median price is $786.00, which is lower than the facility's negotiated rates with most major payers. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For individuals with high-deductible plans, paying the cash price of $786.00 upfront may result in lower out-of-pocket costs compared to the allowed amounts charged by insurers like UnitedHealthcare or Aetna, whose negotiated rates can reach up to $925.00. It is advisable to contact the hospital directly to confirm "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing the costly claims processing cycle.
The facility's pricing is benchmarked against the Medicare rate of $243.77, which serves as a scientifically validated baseline for the true cost of care. Commercial negotiated rates for this procedure average between 200% and 300% of the Medicare amount, whereas fair pricing is typically defined as 120% to 150% of this federal rate. Although specific county or state average data was not provided in the report, the significant markup between the Medicare benchmark and the facility's cash price highlights the importance of comparing rates against federal standards rather than the hospital's full chargemaster list. Consumers should request an itemized billing audit to ensure no errors, such as unbundled codes or services not rendered, are inflating the total, and should dispute any balance bills