CMS Price Transparency Data

MRI, knee or other leg joint

Facility: William Newton Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $700
  • Cash Discount Price: $1,945
  • vs. Medicare Baseline: 2.87x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at William Newton Hospital is $700. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,945. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.87x the Medicare baseline. Located in 1300 East Fifth Avenue, Winfield, KS.
Cash / Self-Pay
$1,945

Average discount available for prompt cash payment at this facility.

Insurance Median
$700

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: $1,945 (798%)
Insurance Median: $700 (287%)
Cash: $1,945 (798% of Medicare)
Ins. Median: $700 (287% 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 287% of the Medicare baseline (a markup of 187%). 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 $525 - $700 215%
Triwest- All Plans $679 279%
Ambetter / Centene $700 - $1,945 287%
UnitedHealthcare $700 - $1,750 287%
Providrs Care Nexus $1,190 488%
Providrs Care - All Other Plans $1,361 558%

Consumer Guidance & Cost Commentary

For the MRI of a knee or other leg joint at William Newton Hospital in Winfield, KS, the cash price is $1,945, which matches the facility's median negotiated rate. This cash price is significantly higher than the state average for this procedure, indicating that paying out-of-pocket here would likely result in a higher total cost compared to other facilities in Kansas. While commercial payers like Blue Cross Blue Shield and Triwest have negotiated rates ranging from $525 to $700, these amounts are often subject to deductibles and co-pays, meaning the actual patient responsibility could exceed the cash price. Patients with high-deductible plans should verify their specific deductible status before scheduling, as paying the full cash price upfront might be more cost-effective than waiting for insurance to cover the service, especially if the negotiated rate exceeds the cash amount.

To ensure you are receiving the most accurate pricing, it is crucial to request an itemized billing audit before finalizing payment, as summary bills often obscure individual charges or unbundled codes that could be disputed. Additionally, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within a short window, effectively bypassing administrative fees and insurance processing costs. While the facility's Medicare benchmark is $243.77, commercial rates are typically marked up significantly above this baseline; however, the cash price of $1,945 remains the most transparent figure for patients without insurance coverage. Always confirm the facility's self-pay classification prior to check-in to avoid automatic claims submission that could void any potential cash discounts.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1300 East Fifth Avenue, Winfield, KS 67156
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals