CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Novant Health Presbyterian Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,557
Cash Discount Price: $1,530
vs. Medicare Baseline: 6.39x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Novant Health Presbyterian Medical Center is $1,557. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,530. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.39x the Medicare baseline. Located in 200 Hawthorne Lane Box 33549, Charlotte, NC.

Cash / Self-Pay

$1,530

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,557

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: $1,530 (628%)

Insurance Median: $1,557 (639%)

Cash: $1,530 (628% of Medicare)

Ins. Median: $1,557 (639% 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 639% of the Medicare baseline (a markup of 539%). 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	$232 - $1,979	95%
Humana	$232 - $2,416	95%
Pace Of The Southern Piedmont	$232	95%
UnitedHealthcare	$232 - $1,959	95%
Aetna	$238 - $2,684	98%
Cigna	$239 - $1,728	98%
Liberty Health	$243	100%
Carolina Complete	$462 - $584	190%
Nc Department Of Public Safety	$462 - $584	190%
Amerihealth	$471 - $596	193%
Wellcare	$471 - $596	193%
Caresource North Carolina	$875 - $1,107	359%
Atlantic Corporation Dba Atlantic Packaging	$1,220 - $1,543	500%
Amps	$1,459 - $1,845	599%
Plotkin Health	$1,592 - $2,013	653%
Medcost	$1,884 - $2,516	773%
Primary Physician Care	$1,963 - $2,483	805%
Multiplan	$1,990 - $2,516	816%
Phcs	$1,990 - $2,516	816%
Employers Choice Network	$2,573 - $3,254	1056%
Three Rivers Provider Network	$2,573 - $3,254	1056%

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 $1,530.
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 Presbyterian 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.