CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Essentia Health Sandstone

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,338
Cash Discount Price: $2,104
vs. Medicare Baseline: 5.49x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Essentia Health Sandstone is $1,338. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,104. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.49x the Medicare baseline. Located in 705 Lundorff Drive South, Sandstone, MN.

Cash / Self-Pay

$2,104

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,338

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: $2,104 (863%)

Insurance Median: $1,338 (549%)

Cash: $2,104 (863% of Medicare)

Ins. Median: $1,338 (549% 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 549% of the Medicare baseline (a markup of 449%). 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
Primewest	$236	97%
Itasca Med Care	$242	99%
Blue Cross Blue Shield	$1,093 - $2,286	448%
Blue Plus Pmap Pcc Prime	$1,093	448%
Medica Access	$1,133	465%
Healthpartners Care Pmap	$1,144	469%
Sanford Healthplan	$1,221 - $1,285	501%
Advocare/Security Health	$1,338	549%
Freedom Blue Ppo	$1,338	549%
Healthpartners Care Msho / Mcr Adv	$1,338	549%
Imcare Msho Pcc Prime	$1,338	549%
Imcare Msho Ref Req	$1,338	549%
Medica Advantage Solutions	$1,338	549%
Medica Msho/Dual Solutions	$1,338	549%
Medica Prime Solution Group	$1,338	549%
Medicare (plans)	$1,338	549%
Nd Va Administration	$1,338	549%
Platinum Blue/Vantage Blue	$1,338	549%
Primewest Msho	$1,338	549%
Secure Blue Msho	$1,338	549%
Ubh Cost Plan	$1,338	549%
Ubh Msho	$1,338	549%
Ucare Msho	$1,338	549%
UnitedHealthcare	$1,338 - $2,591	549%
Ucare	$1,873	768%
Healthpartners	$1,925 - $2,221	790%
Medica	$2,036 - $2,263	835%
Medica Uplan	$2,036	835%
Wea	$2,050 - $2,192	841%
America'S Ppo	$2,206	905%
Cigna	$2,221	911%
Healthpartners Pcc Prime	$2,221	911%
Medica Choice	$2,332	957%
Wps	$2,391	981%
Aetna	$2,420	993%
Security Health	$2,847	1168%

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 $2,104.
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 Essentia Health Sandstone 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.