MRI, knee or other leg joint
Facility: Morris County Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $1,163
- Cash Discount Price: $1,789
- vs. Medicare Baseline: 4.77x 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 477% of the Medicare baseline (a markup of 377%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $264 | 108% |
| Blue Cross Blue Shield | $525 - $1,163 | 215% |
| Coventry Mcr | $1,163 | 477% |
| Va Ccn-All Plans | $1,163 | 477% |
| UnitedHealthcare | $1,163 - $2,982 | 477% |
| Choice Care Mcr Adv-All Plans | $1,163 | 477% |
| Cigna | $2,157 | 885% |
| Aetna | $2,672 | 1096% |
| Coventry Comm-All Other Plans | $2,684 | 1101% |
| Multiplan-All Plans | $2,684 | 1101% |
Consumer Guidance & Cost Commentary
For this MRI procedure at Morris County Hospital in Council Grove, Kansas, the cash median price is $1,789, which is significantly lower than the facility's gross charge of $2,982. While the hospital's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range from $1,163 to $2,982, the cash price remains a strong option for patients with high-deductible plans or those without insurance. It is important to note that cash payments can sometimes be cheaper than insurance reimbursement if the negotiated rate exceeds the cash price, so patients should always verify their specific plan's allowed amount before scheduling. Additionally, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing administrative fees associated with insurance claims.
The facility's pricing is evaluated against the Medicare benchmark of $243.77, which serves as the objective baseline for healthcare costs in this region. Although the Medicare amount is the lowest figure in the dataset, commercial negotiated rates typically average 200% to 300% of this baseline, while fair pricing is often defined as 120% to 150%. For this specific service, the cash median of $1,789 represents a substantial markup over the Medicare rate, reflecting the administrative costs and profit margins inherent in commercial billing. Consumers are advised to request a full itemized CPT-coded bill before paying, as summary invoices may obscure individual charges, and to dispute any balance bills immediately if they arise from out-of-network ancillary services, as federal protections under the No Surprises Act may apply.