CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Blue Ridge Regional Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $2,374
  • Cash Discount Price: $5,848
  • vs. Medicare Baseline: 9.74x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Blue Ridge Regional Hospital is $2,374. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,848. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.74x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
$5,848

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,374

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: $5,848 (2399%)
Insurance Median: $2,374 (974%)
Cash: $5,848 (2399% of Medicare)
Ins. Median: $2,374 (974% 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 974% of the Medicare baseline (a markup of 874%). 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
Blue Cross Blue Shield $936 - $981 384%
United $996 - $2,766 409%
Wellcare $1,011 415%
Amerihealth $1,020 418%
Partners Health Management $1,030 423%
Vaya Health $1,030 423%
Aetna $1,170 - $4,228 480%
Apex Health $1,170 480%
Cigna $1,988 - $2,392 816%
Amerihealth Caritas $2,164 888%
Caresource $2,573 1056%
Medcost $2,725 - $3,027 1118%
Magellan $3,509 1439%
Magellan Behavioral Health $3,509 1439%
Multiplan $4,678 1919%
Avalon Administrative Services $4,971 2039%
Prime Health $5,146 - $5,263 2111%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals