CMS Price Transparency Data

MRI, knee or other leg joint

Facility: North Carolina Baptist Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,157
  • Cash Discount Price: $1,702
  • vs. Medicare Baseline: 4.75x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at North Carolina Baptist Hospital is $1,157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,702. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.75x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$1,702

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,157

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: $1,702 (698%)
Insurance Median: $1,157 (475%)
Cash: $1,702 (698% of Medicare)
Ins. Median: $1,157 (475% 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 475% of the Medicare baseline (a markup of 375%). 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.

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
Aetna $234 - $2,971 96%
Apex $234 96%
Blue Cross Blue Shield $234 - $1,545 96%
Cigna $234 - $2,097 96%
Devoted $234 96%
Healthteam $234 96%
UnitedHealthcare $234 - $1,781 96%
Wellcare $234 - $800 96%
Humana $236 - $1,912 97%
Medicare (plans) $236 97%
Liberty $269 110%
Medcost $656 - $2,324 269%
Amerihealth $749 - $942 307%
Carolina Complete $749 - $790 307%
Health Blue $749 - $790 307%
Partners $749 - $790 307%
Vaya $756 - $798 310%
Alliance $763 - $806 313%
Trillium $771 - $814 316%
Ambetter / Centene $894 - $944 367%
Oscar $994 - $1,258 408%
Directnet $1,957 - $2,066 803%
Cone Health $2,318 - $2,446 951%
Healthgram $2,318 - $2,446 951%
First Carolina Care $2,650 - $2,796 1087%
Private Healthcare Systems $2,716 - $2,866 1114%
Multiplan $2,981 - $3,146 1223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals