MRI, knee or other leg joint
Facility: Smith County Memorial Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $917
- Cash Discount Price: $975
- vs. Medicare Baseline: 3.76x 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 376% of the Medicare baseline (a markup of 276%). 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 | $521 | 214% |
| Medicaid / KanCare | $682 - $975 | 280% |
| Multiplan-All Plans | $878 | 360% |
| Wppa-All Plans | $916 | 376% |
| UnitedHealthcare | $926 | 380% |
| Midlands Choice-All Plans | $926 | 380% |
| Health Partners Of Ks Ppo-All Plans | $926 | 380% |
Consumer Guidance & Cost Commentary
For the MRI of a knee or other leg joint at Smith County Memorial Hospital in Smith Center, Kansas, the cash price is $975.00, which matches the facility's median negotiated rate of $917.00. While the hospital is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance rates can sometimes exceed cash prices due to administrative overhead and contract structures. In this specific case, the cash price is identical to the negotiated amount, meaning there is no financial advantage to paying out-of-pocket for this service. However, patients with high-deductible plans should still verify their specific plan details, as some commercial payers may negotiate rates higher than the cash price, making upfront payment a viable option to avoid potential balance billing or unexpected out-of-pocket costs.
When evaluating the cost of this procedure, it is important to compare the facility's rates against the Medicare benchmark, which serves as the objective baseline for healthcare pricing. The Medicare amount for this code is $243.77, and the facility's cash price represents a 3.8x markup relative to this federal rate. This significant difference highlights how commercial rates often include additional costs for physician work, practice expenses, and malpractice insurance that are not reflected in the government's fixed reimbursement. While the facility does not have a publicly available rating, the data indicates that the negotiated rate of $917.00 is consistent across multiple payers, including Blue Cross Blue Shield, Medicaid/KanCare, and UnitedHealthcare, providing a clear picture of the expected cost for in-network members.