MRI, knee or other leg joint
Facility: St Luke Hospital & Living Center
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $1,299
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 5.33x 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 533% of the Medicare baseline (a markup of 433%). 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 |
|---|---|---|
| Kansas Department Of Health And Environment | $1,299 | 533% |
| Blue Cross Blue Shield | $1,299 | 533% |
| UnitedHealthcare | $1,299 | 533% |
| Va Ccn | $1,299 | 533% |
| Bluestem Pace | $1,299 | 533% |
| Humana | $1,299 | 533% |
| Ambetter / Centene | $1,312 | 538% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate is $1,299.00, which aligns exactly with the lowest and highest negotiated rates observed across all seven payers, including Blue Cross Blue Shield, UnitedHealthcare, and Humana. This specific rate is significantly higher than the Medicare benchmark of $243.77, reflecting a markup common in commercial contracts where administrative processing and network tiering add substantial overhead. While the facility is a Critical Access Hospital owned by a Government Hospital District, the data does not provide a specific county or state average for comparison, so the $1,299.00 negotiated amount serves as the definitive benchmark for in-network members of these carriers.
For patients with high-deductible plans, the cash price for this service is not listed in the current data, but it is important to note that cash-pay options can sometimes result in lower out-of-pocket costs if the insurance negotiated rate exceeds the cash price. Since the facility offers a prompt-pay discount for upfront payment, patients should explicitly request a "self-pay" or "prompt-pay" rate before scheduling to avoid being billed the full $1,299.00. Additionally, because the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients can be confident that the facility will not bill them for the difference between the chargemaster and the insurance allowed amount, provided the service is covered under their plan.