CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Novant Health Forsyth Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,284
Cash Discount Price: $1,281
vs. Medicare Baseline: 5.27x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Novant Health Forsyth Medical Center is $1,284. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,281. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.27x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$1,281

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,284

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: $1,281 (525%)

Insurance Median: $1,284 (527%)

Cash: $1,281 (525% of Medicare)

Ins. Median: $1,284 (527% 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 527% of the Medicare baseline (a markup of 427%). 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
Blue Cross Blue Shield	$231 - $1,798	95%
Humana	$231 - $2,039	95%
Pace Of The Southern Piedmont	$231	95%
UnitedHealthcare	$231 - $1,761	95%
Aetna	$237 - $2,094	97%
Cigna	$238 - $1,554	98%
Liberty Health	$243	100%
Carolina Complete	$272 - $486	112%
Nc Department Of Public Safety	$272 - $486	112%
Amerihealth	$277 - $496	114%
Wellcare	$277 - $496	114%
Caresource North Carolina	$586 - $1,047	240%
Atlantic Corporation Dba Atlantic Packaging	$827 - $1,479	339%
Plotkin Health	$878 - $1,570	360%
Amps	$952 - $1,701	391%
Medcost	$1,244 - $2,460	510%
Primary Physician Care	$1,288 - $2,303	528%
Beechstreet	$1,318 - $2,355	541%
Multiplan	$1,318 - $2,355	541%
Phcs	$1,318 - $2,355	541%
Employers Choice Network	$1,420 - $2,538	583%
Three Rivers Provider Network	$1,420 - $2,538	583%

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 $1,281.
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 Novant Health Forsyth Medical Center 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.