CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Holland Community Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $738
Cash Discount Price: $1,130
vs. Medicare Baseline: 3.03x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Holland Community Hospital is $738. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,130. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.03x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.

Cash / Self-Pay

$1,130

Average discount available for prompt cash payment at this facility.

Insurance Median

$738

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: $1,130 (464%)

Insurance Median: $738 (303%)

Cash: $1,130 (464% of Medicare)

Ins. Median: $738 (303% 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 303% of the Medicare baseline (a markup of 203%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Life Circles-All Plans	$226	93%
Health Alliance Mcr Adv	$238	98%
Ph Mcr Adv	$238	98%
Va Ccn - All Plans	$238	98%
Aetna	$245 - $254	101%
Longevity Health Plan-All Plans	$257	105%
Blue Cross Blue Shield	$359	147%
Cofinity -All Plans	$422	173%
Health Alliance Hmo	$539	221%
Asr - All Plans	$563	231%
Health Alliance Ahl - All Other Plans	$563	231%
Molina Mcaid - All Plans	$588 - $618	241%
Ph Mcaid	$588 - $618	241%
Cigna	$669	274%
Sisco Epi	$738	303%
Sisco-All Other Plans	$738	303%
Priority Health - All Other Plans	$741	304%
Multiplan - All Plans	$1,599 - $1,679	656%
Benefit Source Inc-All Plans	$1,654 - $1,737	679%
First Health-All Plans	$1,654 - $1,737	679%
Usa Managed Care-All Plans	$1,654 - $1,737	679%
Integrated Health Plans-All Plans	$1,746 - $1,834	716%
UnitedHealthcare	$1,838 - $1,930	754%
Nomi Health - All Plans	$3,768 - $3,956	1546%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,130.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73721.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Holland Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73721.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.