CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Wilkes Regional Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,789
Cash Discount Price: $1,752
vs. Medicare Baseline: 7.34x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Wilkes Regional Medical Center is $1,789. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,752. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.34x the Medicare baseline. Located in 1370 West D St, North Wilkesboro, NC.

Cash / Self-Pay

$1,752

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,789

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: $1,752 (719%)

Insurance Median: $1,789 (734%)

Cash: $1,752 (719% of Medicare)

Ins. Median: $1,789 (734% 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 734% of the Medicare baseline (a markup of 634%). 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
Healthteam	$238	98%
Amerihealth	$656 - $2,036	269%
Carolina Complete	$656	269%
Healthblue	$656	269%
Partners	$656	269%
UnitedHealthcare	$662 - $1,871	272%
Vaya	$662	272%
Wellcare	$662	272%
Alliance	$669	274%
Trillium	$675	277%
Medcost	$1,009 - $2,502	414%
Blue Cross Blue Shield	$1,217 - $2,045	499%
Aetna	$1,332 - $2,407	546%
Ambetter / Centene	$1,482 - $2,134	608%
Cigna	$1,836 - $1,899	753%
Oscar	$1,927 - $2,278	790%
Directnet	$2,071	850%
Private Healthcare Systems	$3,154	1294%
Multiplan	$3,224	1323%

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 $1,752.
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 Wilkes Regional 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.