CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Memorial Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $2,154
  • Cash Discount Price: $3,917
  • vs. Medicare Baseline: 8.84x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Memorial Hospital is $2,154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,917. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.84x the Medicare baseline. Located in 511 Ne 10Th St, Abilene, KS.
Cash / Self-Pay
$3,917

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,154

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: $3,917 (1607%)
Insurance Median: $2,154 (884%)
Cash: $3,917 (1607% of Medicare)
Ins. Median: $2,154 (884% 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 884% of the Medicare baseline (a markup of 784%). 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 $556 228%
Humana $1,958 803%
Tricare $1,958 803%
Medicare (plans) $1,978 811%
Ambetter / Centene $2,154 884%
Coventry - All Other Plans $3,525 1446%
Health Partners Of Kansas - All Plans $3,721 1526%
Preferred Healthcare-All Plans $3,721 1526%
Wppa/Providers Care-All Plans $5,484 2250%

Consumer Guidance & Cost Commentary

For the MRI of a knee or other leg joint at Memorial Hospital in Abilene, KS, the cash price is $3,917, which matches the facility's median negotiated rate for in-network payers. While the facility is a Critical Access Hospital with a government ownership structure, the cash price is significantly higher than the Medicare benchmark of $243.77, reflecting a markup common in commercial billing. Patients with high-deductible plans or those without insurance may find the cash price more affordable than the negotiated rate of $2,154, as the insurance payment often exceeds the cash amount, leaving the patient responsible for the difference. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket costs than paying cash upfront.

To minimize costs, consumers should proactively request "self-pay" or "prompt-pay" discounts before check-in, which can reduce the bill by 20% to 50% by bypassing administrative claim processing fees. Since over 80% of hospital bills contain errors, it is advisable to demand a full itemized CPT-coded bill rather than accepting a summary invoice, ensuring no unbundled codes or services not rendered are included. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still review their itemized statement carefully to dispute any discrepancies. For this specific procedure, the facility's pricing is notably higher than the national average, so comparing the cash price against your personal financial situation and potential discounts is the most effective way to determine the best payment option.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 511 Ne 10Th St, Abilene, KS 67410
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals