CMS Price Transparency Data
MRI, knee or other leg joint
Facility: Mercy Hospital Lebanon
Billing Code: 73721 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73721
- Insurance Median: $3,172
- Cash Discount Price: $3,222
- vs. Medicare Baseline: 13.01x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mercy Hospital Lebanon is $3,172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,222. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 13.01x the Medicare baseline. Located in 100 Hospital Drive, Lebanon, MO.
Cash / Self-Pay
$3,222
Average discount available for prompt cash payment at this facility.
Insurance Median
$3,172
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: $3,222 (1322%)
Insurance Median: $3,172 (1301%)
Cash: $3,222 (1322% of Medicare)
Ins. Median: $3,172 (1301% 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 1301% of the Medicare baseline (a markup of 1201%). 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.
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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 | $120 - $471 | 49% |
| Medicare (plans) | $221 - $234 | 91% |
| Aetna | $230 - $2,224 | 94% |
| Blue Cross Blue Shield | $230 - $1,604 | 94% |
| Champva [20065] | $230 | 94% |
| Cherokee Nation Health Serv Contracted [320066] | $230 | 94% |
| Cigna | $230 - $4,402 | 94% |
| Cross Timbers Hospice [20098] | $230 | 94% |
| Dept Of Veteran Affairs Contracted [320106] | $230 | 94% |
| Elara Caring Aspire Hospice [20433] | $230 | 94% |
| Globalhealth Contracted [320145] | $230 | 94% |
| Halo Hcr Inc Hospice Contracted [320432] | $230 | 94% |
| Halo Hcr Inc Hospice [20432] | $230 | 94% |
| Humana | $230 - $5,056 | 94% |
| Kindful Hospice Contracted [320434] | $230 | 94% |
| Kindful Hospice [20434] | $230 | 94% |
| Mercy Hospice Okc [20252] | $230 | 94% |
| Mercy Mgd Behavioral Health Contracted [320259] | $230 | 94% |
| Pace Of The Ozarks Contracted [320518] | $230 | 94% |
| Provider Partners Health Plans Contracted [320450] | $230 | 94% |
| Qual Choice Contracted [320325] | $230 | 94% |
| Tricare | $230 | 94% |
| UnitedHealthcare | $230 - $5,651 | 94% |
| Healthscope Contracted [320182] | $293 | 120% |
| Centivo Contracted [320505] | $387 | 159% |
| Ambetter / Centene | $471 | 193% |
| Home State Health Plan Contracted [320187] | $471 | 193% |
| Novasys Contracted [320285] | $471 | 193% |
| Medica Contracted [320239] | $1,203 | 493% |
| Medica [20239] | $1,203 | 493% |
| Administrative Payor Contracted [320005] | $1,784 - $2,677 | 732% |
| Healthlink Contracted [320179] | $2,577 - $5,056 | 1057% |
| Preferred Health Plan Contracted [320522] | $2,577 - $3,866 | 1057% |
| 90 Degree Benefits Contracted [320436] | $2,974 - $4,461 | 1220% |
| Mercy Benefit Admin Contracted [320251] | $2,974 - $4,758 | 1220% |
| Show-Me Health Administrators Contracted [320483] | $2,974 - $4,461 | 1220% |
| United Medical Resources Contracted [320454] | $2,974 - $4,758 | 1220% |
| Aither Health Contracted [320449] | $3,172 - $4,758 | 1301% |
| Auxiant Contracted [320462] | $3,172 - $4,758 | 1301% |
| Benefit Management Contracted [320052] | $3,172 - $4,758 | 1301% |
| Ebms Contracted [320493] | $3,172 - $4,758 | 1301% |
| Edison Health Solutions Contracted [320502] | $3,172 - $4,758 | 1301% |
| Evolutions Health Care Contracted [320124] | $3,172 - $4,758 | 1301% |
| First Health Contracted [320128] | $3,172 - $4,758 | 1301% |
| Health Systems Inc Contracted [320174] | $3,172 - $4,758 | 1301% |
| Imagine 360 Contracted [320494] | $3,172 - $4,758 | 1301% |
| Insurance System Inc Contracted [320465] | $3,172 - $4,758 | 1301% |
| Point C Contracted [320238] | $3,172 - $5,651 | 1301% |
| Point C [20238] | $3,172 - $4,758 | 1301% |
| Reflect Health Contracted [320492] | $3,172 - $4,758 | 1301% |
| Workers Comp [20426] | $3,172 - $5,056 | 1301% |
| Yuzu Health Contracted [320521] | $3,172 - $4,758 | 1301% |
| American Healthcare Alliance Contracted [320020] | $3,370 - $5,056 | 1382% |
| Usa Managed Care Org Contracted [320429] | $3,489 - $5,234 | 1431% |
| Multiplan Contracted [320270] | $3,767 - $5,651 | 1545% |
| Private Health Care Systems Contracted [320320] | $3,767 - $5,651 | 1545% |