MRI, knee or other leg joint
Facility: Community Memorial Healthcare, Inc.
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $1,304
- Cash Discount Price: $2,527
- vs. Medicare Baseline: 5.35x 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 535% of the Medicare baseline (a markup of 435%). 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 | 227% |
| Aetna | $1,162 - $1,895 | 477% |
| UnitedHealthcare | $1,445 | 593% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at Community Memorial Healthcare, Inc. in Marysville, KS, the cash median price is $2,527.00, which matches the facility's gross charge. While the facility's negotiated rates with major payers like Aetna and UnitedHealthcare range from $1,162 to $1,895, these amounts are still higher than the cash price. This is a common scenario where paying out-of-pocket can be more cost-effective for patients with high-deductible plans, as the insurance negotiated rate often exceeds the cash price. To maximize savings, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final bill.
The facility's pricing is also contextualized by state and county benchmarks, with the cash median of $2,527.00 representing a 5.3% markup compared to the Medicare amount of $243.77. Although commercial rates are typically higher than Medicare due to administrative costs and contract structures, the significant difference between the cash price and the negotiated rates suggests that paying directly may result in lower out-of-pocket costs. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but it is crucial to verify network status and request an itemized bill to ensure no unexpected charges occur.