CMS Price Transparency Data
MRI, knee or other leg joint
Facility: Trinity Health Oakland Hospital
Billing Code: 73721 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73721
- Insurance Median: $1,802
- Cash Discount Price: $2,970
- vs. Medicare Baseline: 7.39x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Trinity Health Oakland Hospital is $1,802. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,970. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.39x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$2,970
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,802
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: $2,970 (1218%)
Insurance Median: $1,802 (739%)
Cash: $2,970 (1218% of Medicare)
Ins. Median: $1,802 (739% 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 739% of the Medicare baseline (a markup of 639%). 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 |
|---|---|---|
| Medicaid / KanCare | $131 - $133 | 54% |
| Blue Cross Blue Shield | $133 - $635 | 55% |
| Aetna | $155 - $2,617 | 64% |
| Geha | $155 - $4,333 | 64% |
| Medical Mutual | $155 - $176 | 64% |
| Meritain | $155 - $176 | 64% |
| Bcn Domestic | $199 - $635 | 82% |
| Blue Benefit Administrators Of Massachusetts | $199 - $635 | 82% |
| Blue Care Network | $199 - $635 | 82% |
| Blue Distinction Transplant | $199 - $635 | 82% |
| Blue Shield - Ca | $199 - $635 | 82% |
| Blue Shield - Id (Regence) | $199 - $635 | 82% |
| Blue Shield - Ny Highmark Northeastern | $199 - $635 | 82% |
| Blue Shield - Ny Highmark Western | $199 - $635 | 82% |
| Blue Shield - Pa (Highmark) | $199 - $635 | 82% |
| Blue Shield - Wa (Regence) | $199 - $635 | 82% |
| Health Choices | $199 - $4,240 | 82% |
| Kaiser Domestic | $199 - $635 | 82% |
| Blue Care Network Advantage | $233 | 96% |
| Medicare (plans) | $233 - $238 | 96% |
| Align Senior Care | $238 | 98% |
| Hospice Advantage | $238 | 98% |
| UnitedHealthcare | $245 - $4,333 | 101% |
| Cca - Zing Health | $252 | 103% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $268 | 110% |
| Molina Marketplace | $309 | 127% |
| Health Cost Solutions | $368 | 151% |
| Vitalcore | $368 | 151% |
| Wellpath | $368 | 151% |
| U Of M Health Plan | $425 - $451 | 174% |
| Priority Health | $504 - $1,134 | 207% |
| Employee Benefit Logistic | $549 | 225% |
| Asr Health Benefits | $696 - $772 | 286% |
| Caresource | $696 - $772 | 286% |
| Hap | $696 - $4,206 | 286% |
| Varipro | $696 - $772 | 286% |
| Wc Accident Fund | $1,169 - $1,753 | 480% |
| Wc Advantage | $1,169 - $1,753 | 480% |
| Wc Aig | $1,169 - $1,753 | 480% |
| Wc Allied | $1,169 - $1,753 | 480% |
| Wc Amerisure | $1,169 - $1,753 | 480% |
| Wc Amtrust | $1,169 - $1,753 | 480% |
| Wc Asu Risk Mgt | $1,169 - $1,753 | 480% |
| Wc Berkley Admin | $1,169 - $1,753 | 480% |
| Wc Broadspire | $1,169 - $1,753 | 480% |
| Wc Bunch & Associates | $1,169 - $1,753 | 480% |
| Wc Ccmsi | $1,169 - $1,753 | 480% |
| Wc Emc Insurance Company | $1,169 - $1,753 | 480% |
| Wc Esis | $1,169 - $1,753 | 480% |
| Wc Fcci | $1,169 - $1,753 | 480% |
| Wc Federated | $1,169 - $1,753 | 480% |
| Wc Gallagher Bassett | $1,169 - $1,753 | 480% |
| Wc Genex Care For Ohio | $1,169 - $1,753 | 480% |
| Wc Guard Insurance Company | $1,169 - $1,753 | 480% |
| Wc Hartford | $1,169 - $1,753 | 480% |
| Wc Liberty Mutual | $1,169 - $1,753 | 480% |
| Wc Meijers | $1,169 - $1,753 | 480% |
| Wc Michigan | $1,169 - $1,753 | 480% |
| Wc Mitchell Frankenmuth | $1,169 - $1,753 | 480% |
| Wc Pma | $1,169 - $1,753 | 480% |
| Wc Sedgwick | $1,169 - $1,753 | 480% |
| Wc Sentry | $1,169 - $1,753 | 480% |
| Wc Travelers | $1,169 - $1,753 | 480% |
| Wc Tristar | $1,169 - $1,753 | 480% |
| Wc Walmart | $1,169 - $1,753 | 480% |
| Wc Zurich | $1,169 - $1,753 | 480% |
| Acs Benefit Services | $1,694 - $2,542 | 695% |
| Allied Benefit Systems | $1,694 - $2,542 | 695% |
| Claimchoice Adminstrators | $1,694 - $2,542 | 695% |
| Consociate | $1,694 - $2,542 | 695% |
| Cypress Benefit Administrators | $1,694 - $2,542 | 695% |
| Forest County Potawatomi | $1,694 - $2,542 | 695% |
| Health Smart | $1,694 - $2,542 | 695% |
| Healthgram | $1,694 - $2,542 | 695% |
| Healthscope | $1,694 - $2,542 | 695% |
| Secureone Preferred United Plans | $1,694 - $2,542 | 695% |
| Sisco Benefits | $1,694 - $2,542 | 695% |
| The Health Plan | $1,694 - $2,542 | 695% |
| Trustmark Small Business Benefits | $1,694 - $2,542 | 695% |
| Unified Group Services | $1,694 - $2,542 | 695% |
| Webtpa | $1,694 - $2,542 | 695% |
| Mclaren Health | $1,851 - $3,029 | 759% |
| Carelon Behavioral Health | $1,926 - $2,888 | 790% |
| Magellan Behavioral Health | $2,311 - $3,466 | 948% |
| 1199 National Benefit Fund | $2,619 - $3,928 | 1074% |
| Allied National Global Care | $2,619 - $3,928 | 1074% |
| Asrm - Reliance Standard Life Insurance | $2,619 - $3,928 | 1074% |
| Christian Care Ministry | $2,619 - $3,928 | 1074% |
| Dean Health | $2,619 - $3,928 | 1074% |
| Fallon Health | $2,619 - $3,928 | 1074% |
| Family Life Insurance Company | $2,619 - $3,928 | 1074% |
| Ghc Scw | $2,619 - $3,928 | 1074% |
| Group Pension Administrators | $2,619 - $3,928 | 1074% |
| International Benefit Administrators | $2,619 - $3,928 | 1074% |
| Lifetime Benefit Solutions | $2,619 - $3,928 | 1074% |
| Manhattan Life | $2,619 - $3,928 | 1074% |
| Medi Share | $2,619 - $3,928 | 1074% |
| Multiplan | $2,619 - $3,928 | 1074% |
| Mvp | $2,619 - $3,928 | 1074% |
| Pai | $2,619 - $3,928 | 1074% |
| Pan-American Life | $2,619 - $3,928 | 1074% |
| Paramount Hmo | $2,619 - $3,928 | 1074% |
| Phcs | $2,619 - $3,928 | 1074% |
| Trinity Health Share | $2,619 - $3,928 | 1074% |
| Health Partners | $2,804 - $4,206 | 1150% |
| Tufts Health Plan | $2,804 - $4,206 | 1150% |
| Access Health | $2,827 - $4,240 | 1160% |
| Acclaim | $2,827 - $4,240 | 1160% |
| Administrative Concepts | $2,827 - $4,240 | 1160% |
| Allegeant | $2,827 - $4,240 | 1160% |
| Ameriben | $2,827 - $4,240 | 1160% |
| American Family | $2,827 - $4,240 | 1160% |
| American Healthcare Alliance | $2,827 - $4,240 | 1160% |
| American National | $2,827 - $4,240 | 1160% |
| American Republic | $2,827 - $4,240 | 1160% |
| Amerihealth | $2,827 - $4,240 | 1160% |
| Aultcare | $2,827 - $4,240 | 1160% |
| Automated Benefit Services | $2,827 - $4,240 | 1160% |
| Auxiant | $2,827 - $4,240 | 1160% |
| Benefit Administrative Systems,Llc | $2,827 - $4,240 | 1160% |
| Boon Chapman | $2,827 - $4,240 | 1160% |
| Cam Administrative Services | $2,827 - $4,240 | 1160% |
| Christian Brother Services | $2,827 - $4,240 | 1160% |
| Christian Brothers Holy Cross | $2,827 - $4,240 | 1160% |
| Comprehensive Benefits | $2,827 - $4,240 | 1160% |
| Continental Life Insurance | $2,827 - $4,240 | 1160% |
| Custom Benefit Administrators | $2,827 - $4,240 | 1160% |
| Employee Benefit Concepts | $2,827 - $4,240 | 1160% |
| Employee Benefit Management | $2,827 - $4,240 | 1160% |
| Enterprise Group Planning | $2,827 - $4,240 | 1160% |
| Freedom Life Insurance Company | $2,827 - $4,240 | 1160% |
| Group Administrators | $2,827 - $4,240 | 1160% |
| Group Marketing Services | $2,827 - $4,240 | 1160% |
| Guardian | $2,827 - $4,240 | 1160% |
| Health America | $2,827 - $4,240 | 1160% |
| Healthcare Management Admin | $2,827 - $4,240 | 1160% |
| Healthez | $2,827 - $4,240 | 1160% |
| Humana | $2,827 - $4,240 | 1160% |
| Insight | $2,827 - $4,240 | 1160% |
| Intercare | $2,827 - $4,240 | 1160% |
| Jfp Benefit Management | $2,827 - $4,240 | 1160% |
| Jp Farley Corporation | $2,827 - $4,240 | 1160% |
| Key Benefit Administrator | $2,827 - $4,240 | 1160% |
| Liberty Union Life Assurance Co | $2,827 - $4,240 | 1160% |
| Lucent Health | $2,827 - $4,240 | 1160% |
| Luminare Health | $2,827 - $4,240 | 1160% |
| Luminare Health (Detroit) | $2,827 - $4,240 | 1160% |
| Magnacare | $2,827 - $4,240 | 1160% |
| Medben | $2,827 - $4,240 | 1160% |
| Medcost | $2,827 - $4,240 | 1160% |
| Mutual Health Services | $2,827 - $4,240 | 1160% |
| Mutual Of Omaha | $2,827 - $4,240 | 1160% |
| Ncas | $2,827 - $4,240 | 1160% |
| Nippon Life Ins | $2,827 - $4,240 | 1160% |
| Nova | $2,827 - $4,240 | 1160% |
| Painters Union Insurance Fund | $2,827 - $4,240 | 1160% |
| Physicians Mutual | $2,827 - $4,240 | 1160% |
| Plumbers Local 98 Insurance Fund | $2,827 - $4,240 | 1160% |
| Prairie States | $2,827 - $4,240 | 1160% |
| Preferred One | $2,827 - $4,240 | 1160% |
| Primary Physician Care | $2,827 - $4,240 | 1160% |
| Professional Benefit Administrators | $2,827 - $4,240 | 1160% |
| Siho Insurance Services | $2,827 - $4,240 | 1160% |
| The Loomis Company | $2,827 - $4,240 | 1160% |
| Unicare | $2,827 - $4,240 | 1160% |
| Us Health And Life | $2,827 - $4,240 | 1160% |
| Valenz | $2,827 - $4,240 | 1160% |
| Western & Southern Financial Group | $2,827 - $4,240 | 1160% |
| Wps | $2,827 - $4,240 | 1160% |
| Cigna | $2,854 - $4,281 | 1171% |
| Coventry | $2,903 - $4,355 | 1191% |
| First Health | $2,903 - $4,355 | 1191% |
| Prime Health Services | $3,081 - $4,622 | 1264% |
| Three Rivers Provider Network | $3,466 - $5,199 | 1422% |
| Cmh Detroit Wayne Integrated Health Network | $3,851 - $5,777 | 1580% |
| Cmh Lenawee County | $3,851 - $5,777 | 1580% |
| Cmh Livingston County | $3,851 - $5,777 | 1580% |
| Cmh Misc | $3,851 - $5,777 | 1580% |
| Cmh Monroe County | $3,851 - $5,777 | 1580% |
| Cmh Oakland County | $3,851 - $5,777 | 1580% |
| Cmh Washtenaw County | $3,851 - $5,777 | 1580% |