CMS Price Transparency Data

MRI, knee or other leg joint

Facility: The Outer Banks Hospital, Inc

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $3,658
Cash Discount Price: $3,863
vs. Medicare Baseline: 15.01x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at The Outer Banks Hospital, Inc is $3,658. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,863. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 15.01x the Medicare baseline. Located in 4800 South Croatan Highway, Nags Head, NC.

Cash / Self-Pay

$3,863

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,658

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: $3,863 (1585%)

Insurance Median: $3,658 (1501%)

Cash: $3,863 (1585% of Medicare)

Ins. Median: $3,658 (1501% 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 1501% of the Medicare baseline (a markup of 1401%). 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	$1,683 - $5,132	690%
Carolina Complete Health [1317]	$1,770 - $2,729	726%
Wellcare [1320]	$1,779 - $2,743	730%
Amerihealth McAid Adv [1316]	$1,788 - $2,757	733%
Liberty Advantage [1313]	$1,998 - $3,080	820%
UnitedHealthcare	$2,046 - $4,913	839%
Humana	$2,063 - $3,181	846%
Aetna	$2,109 - $6,554	865%
Longevity Health [1411]	$2,470 - $3,808	1013%
Nc Dept of Public Safety [1095]	$3,420 - $5,273	1403%
Medcost [1067]	$3,496 - $5,641	1434%
Cigna	$4,614 - $7,952	1893%
Multiplan [1031]	$5,157 - $7,952	2116%

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 $3,863.
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 The Outer Banks 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.