CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Girard Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,155
  • Cash Discount Price: $1,980
  • vs. Medicare Baseline: 4.74x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Girard Medical Center is $1,155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,980. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.74x the Medicare baseline. Located in 302 North Hospital Drive, Girard, KS.
Cash / Self-Pay
$1,980

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,155

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: $1,980 (812%)
Insurance Median: $1,155 (474%)
Cash: $1,980 (812% of Medicare)
Ins. Median: $1,155 (474% 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 474% of the Medicare baseline (a markup of 374%). 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
Blue Cross Blue Shield $553 - $1,155 227%
Ambetter / Centene $1,155 474%
Medicare (plans) $1,155 474%
Humana $1,155 474%
Kansas Superior Select-All Plans $1,155 474%
UnitedHealthcare $1,155 - $3,135 474%
Aetna $1,155 - $5,775 474%
Multiplan-All Plans $3,052 1252%
Uhhis-All Plans $3,135 1286%

Consumer Guidance & Cost Commentary

For the MRI of the knee or other leg joint at Girard Medical Center in Girard, Kansas, the cash median price is $1,980, while the median negotiated rate paid by insurance plans is $1,155. This facility is a Critical Access Hospital owned by a Government Hospital District, and its pricing reflects the specific contract dynamics of the nine payers listed, ranging from Blue Cross Blue Shield to UnitedHealthcare. It is important to note that while insurance offers a lower negotiated rate of $1,155, patients with high-deductible plans may find the cash price of $1,980 more cost-effective if their out-of-pocket expenses exceed the insurance allowed amount, especially since the cash rate is significantly higher than the Medicare benchmark of $243.77.

To ensure you are not overcharged, always request a full itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a surprise bill, remember that the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities, so you should dispute any unexpected charges in writing rather than paying immediately. Additionally, since this facility offers a prompt-pay discount for upfront payment, you should contact the billing department before scheduling to confirm self-pay rates and waive automatic insurance submission to avoid being billed the full chargemaster gross price.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 302 North Hospital Drive, Girard, KS 66743
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals