MRI, knee or other leg joint
Facility: Golden Valley Memorial Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $243
- Cash Discount Price: $1,818
- vs. Medicare Baseline: 1.00x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Home State Health | $219 | 90% |
| UnitedHealthcare | $219 - $413 | 90% |
| Aetna | $243 | 100% |
| Humana | $243 | 100% |
| Ambetter / Centene | $291 | 119% |
| Medica | $1,208 | 496% |
Consumer Guidance & Cost Commentary
For patients paying cash directly, the most important thing to know is that the self-pay rate for this MRI procedure is $1,818, which is significantly lower than the facility's gross charge of $3,030. Because commercial insurance plans often negotiate rates that can exceed cash prices due to administrative overhead, paying out-of-pocket may sometimes be the most cost-effective option, especially for those with high-deductible plans. If you have insurance, it is crucial to verify your specific plan's allowed amount before scheduling, as some in-network carriers may charge up to $1,208 for this service, while others, like Home State Health and Aetna, have negotiated rates as low as $219.
This procedure's pricing context is further defined by the facility's relationship to state and federal benchmarks. The cash rate of $1,818 is notably higher than the facility's negotiated rate of $243, yet the facility's Medicare rate of $243.77 serves as the objective baseline for evaluating commercial markups. While the facility is a government-owned acute care hospital in Clinton, Missouri, with a rating of 3, patients should request a "prompt-pay" discount at check-in to potentially lower the $1,818 self-pay amount. Additionally, since Medicare rates are calculated based on actual cost reports plus a small margin, they represent the true cost of delivery, whereas commercial rates often include significant administrative layers that inflate the baseline price.