CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Lexington Memorial Hospital Inc

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,588
Cash Discount Price: $1,787
vs. Medicare Baseline: 6.51x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Lexington Memorial Hospital Inc is $1,588. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,787. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.51x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$1,787

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,588

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: $1,787 (733%)

Insurance Median: $1,588 (651%)

Cash: $1,787 (733% of Medicare)

Ins. Median: $1,588 (651% 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 651% of the Medicare baseline (a markup of 551%). 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
Amerihealth	$673 - $982	276%
Carolina Complete	$673	276%
Healthy Blue	$673	276%
Partners	$673	276%
UnitedHealthcare	$680 - $1,601	279%
Vaya	$680	279%
Wellcare	$680	279%
Alliance	$687	282%
Trillium	$694	285%
Medcost	$783 - $2,391	321%
Blue Cross Blue Shield	$994 - $1,593	408%
Aetna	$1,015 - $3,302	416%
Ambetter / Centene	$1,026	421%
Oscar	$1,144 - $1,573	469%
Cigna	$1,555 - $1,583	638%
Directnet	$2,112	866%
Healthgram Lexington Home Brands	$2,573	1056%
Healthgram	$2,859	1173%
Private Healthcare Systems	$2,931	1202%
Beechstreet	$3,145	1290%
Humana	$3,145	1290%
Multiplan	$3,217	1320%
National Provider Network	$3,217	1320%

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 $1,787.
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 Lexington Memorial Hospital Inc 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.