CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $200
Cash Discount Price: $2,428
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Munson Healthcare Otsego Memorial Hospital is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,428. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.82x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$2,428

Average discount available for prompt cash payment at this facility.

Insurance Median

$200

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: $2,428 (996%)

Insurance Median: $200 (82%)

Cash: $2,428 (996% of Medicare)

Ins. Median: $200 (82% 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.

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
Blue Cross Blue Shield	$41 - $1,784	17%
Mclaren Health Plan	$41 - $2,395	17%
Meridian	$41 - $124	17%
Molina	$41 - $257	17%
Priority Health	$41 - $495	17%
UnitedHealthcare	$41 - $2,288	17%
Aetna	$62 - $2,313	25%
Blue Care Network	$62 - $238	25%
Hap (Health Alliance Plan)	$62 - $2,285	25%
Humana	$62 - $238	25%
Medicare (plans)	$62 - $238	25%
Michigan Amish Medical Board	$62 - $238	25%
Northern Michigan Mennonite Group	$62 - $238	25%
Asr Physicians Care Network	$93 - $2,285	38%
Cigna	$96 - $495	39%
Nomi Health	$99 - $2,285	41%
Employee Benefit Logistics	$105 - $404	43%
Munson Hospice	$852 - $1,999	350%
Hospice Of Michigan	$1,714	703%
Enterprise Group Planning/Employee Benefit Plan	$2,285	937%
Cofinity	$2,428	996%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$2,428	996%
Three Rivers Provider Network	$2,428	996%

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 $2,428.
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 Munson Healthcare Otsego Memorial 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.