CMS Price Transparency Data
MRI, knee or other leg joint
Facility: Claiborne Memorial Medical Center
Billing Code: 73721 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73721
- Insurance Median: $2,244
- Cash Discount Price: $2,516
- vs. Medicare Baseline: 9.21x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Claiborne Memorial Medical Center is $2,244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,516. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.21x the Medicare baseline. Located in 620 East College Street, Homer, LA.
Cash / Self-Pay
$2,516
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,244
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: $2,516 (1032%)
Insurance Median: $2,244 (921%)
Cash: $2,516 (1032% of Medicare)
Ins. Median: $2,244 (921% 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 921% of the Medicare baseline (a markup of 821%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Vantage Health Plan Inc | $215 | 88% |
| Ambetter / Centene | $380 | 156% |
| Medicaid / KanCare | $380 - $1,199 | 156% |
| Aetna | $897 - $1,813 | 368% |
| Commercial Insurance | $897 - $2,789 | 368% |
| Meritain Health | $897 - $1,813 | 368% |
| Sedgwick Claims Mgmt Serv | $906 - $2,510 | 372% |
| Workman'S Comp | $906 - $2,510 | 372% |
| Amerihealth Caritas La | $964 - $1,199 | 395% |
| Community Health Solution | $964 - $1,199 | 395% |
| Correctcare Intergrated | $964 - $1,199 | 395% |
| Healthy Blue | $964 - $1,199 | 395% |
| Humana | $964 - $2,789 | 395% |
| Louisiana Hc Connections | $964 - $1,199 | 395% |
| Magellan Services | $964 - $1,199 | 395% |
| UnitedHealthcare | $964 - $1,199 | 395% |
| Blue Cross Blue Shield | $1,270 | 521% |
| Coventry Healthcare | $1,346 - $1,674 | 552% |
| Geha | $1,571 - $1,953 | 644% |
| Health Plus Of La | $1,571 - $2,092 | 644% |
| Apwu Healthplan | $1,683 - $2,092 | 690% |
| Cigna | $1,683 - $2,092 | 690% |
| Great West Healthcare | $1,683 - $2,092 | 690% |
| Phcs | $1,795 - $2,231 | 736% |
| Ppo Plus | $1,795 - $2,231 | 736% |
| Aarp | $2,244 - $2,789 | 921% |
| Accordia National | $2,244 - $2,789 | 921% |
| Aflac | $2,244 - $2,789 | 921% |
| Alameda Alliance Forhealt | $2,244 - $2,789 | 921% |
| American Pioneer | $2,244 - $2,789 | 921% |
| Benefit Management | $2,244 - $2,789 | 921% |
| Benesys Inc | $2,244 - $2,789 | 921% |
| Business Guarantor | $2,244 - $2,789 | 921% |
| Chubb | $2,244 - $2,789 | 921% |
| Commercial Sr. Care | $2,244 - $2,789 | 921% |
| Employee Benefit Services | $2,244 - $2,789 | 921% |
| Family Life Insurance Co | $2,244 - $2,789 | 921% |
| Farm Bureau Insurance | $2,244 - $2,789 | 921% |
| Fiserv Health Benefit | $2,244 - $2,789 | 921% |
| Gmp | $2,244 - $2,789 | 921% |
| Group And Pension Admin | $2,244 - $2,789 | 921% |
| Group Resources | $2,244 - $2,789 | 921% |
| Haik Minvielle And Grubbs | $2,244 - $2,789 | 921% |
| Harrington Benefit Svs | $2,244 - $2,789 | 921% |
| Health Design Plus | $2,244 - $2,789 | 921% |
| Health Plan | $2,244 - $2,789 | 921% |
| Healthscope Benefits | $2,244 - $2,789 | 921% |
| Insurance Management Admi | $2,244 - $2,789 | 921% |
| Jefferson National | $2,244 - $2,789 | 921% |
| John Alden Health Ins | $2,244 - $2,789 | 921% |
| John Hancock | $2,244 - $2,789 | 921% |
| Liberty Mutual | $2,244 - $2,789 | 921% |
| Mailhandlers Benefit Plan | $2,244 - $2,789 | 921% |
| Manhattan Life Ins Co | $2,244 - $2,789 | 921% |
| Mega Life And Health | $2,244 - $2,789 | 921% |
| Msa Careguard | $2,244 - $2,789 | 921% |
| Mutual Of Omaha | $2,244 - $2,789 | 921% |
| Nalc Health Benefit Plan | $2,244 - $2,789 | 921% |
| Naphcare Inc. | $2,244 - $2,789 | 921% |
| New Era Life Ins Co | $2,244 - $2,789 | 921% |
| Physicians Mutual | $2,244 - $2,789 | 921% |
| Principal Financial Group | $2,244 - $2,789 | 921% |
| Prudential Healthcare | $2,244 - $2,789 | 921% |
| Self Pay | $2,244 - $2,789 | 921% |
| State Farm | $2,244 - $2,789 | 921% |
| State Farm Insurance | $2,244 - $2,789 | 921% |
| State Mutual Insurance Co | $2,244 - $2,789 | 921% |
| Sterling Investors Life | $2,244 - $2,789 | 921% |
| Tower Life | $2,244 - $2,789 | 921% |
| Transamerica Premier Ins | $2,244 - $2,789 | 921% |
| United American | $2,244 - $2,789 | 921% |
| United Comm Travelers | $2,244 - $2,789 | 921% |
| United Teachers | $2,244 - $2,789 | 921% |
| Usable Administrator | $2,244 - $2,789 | 921% |
| Visn 16 Cfu | $2,244 - $2,789 | 921% |
| Wausau Benefits | $2,244 - $2,789 | 921% |
| Webtpa | $2,244 - $2,789 | 921% |
| Wells Fargo | $2,244 - $2,789 | 921% |
| Woodmen Of The World | $2,244 - $2,789 | 921% |