CMS Price Transparency Data

MRI, knee or other leg joint

Facility: St Lukes Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $250
Cash Discount Price: $2,221
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at St Lukes Hospital is $250. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,221. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.03x the Medicare baseline. Located in 915 East 1St Street, Duluth, MN.

Cash / Self-Pay

$2,221

Average discount available for prompt cash payment at this facility.

Insurance Median

$250

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: $2,221 (911%)

Insurance Median: $250 (103%)

Cash: $2,221 (911% of Medicare)

Ins. Median: $250 (103% 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
Ucare	$97 - $99	40%
Blue Cross Blue Shield	$111 - $1,091	46%
UnitedHealthcare	$121 - $426	50%
Humana	$126 - $259	52%
Aetna	$139 - $254	57%
Medica	$145 - $426	59%
Healthpartners	$229 - $252	94%
Security Health Plan Of Wisconsin, Inc.	$2,912	1195%

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 $2,221.
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 St Lukes 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.