CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Phelps Memorial Health Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,610
Cash Discount Price: $4,004
vs. Medicare Baseline: 10.71x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Phelps Memorial Health Center is $2,610. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,004. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.71x the Medicare baseline. Located in 1215 Tibbals St, Holdrege, NE.

Cash / Self-Pay

$4,004

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,610

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: $4,004 (1643%)

Insurance Median: $2,610 (1071%)

Cash: $4,004 (1643% of Medicare)

Ins. Median: $2,610 (1071% 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 1071% of the Medicare baseline (a markup of 971%). 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
UnitedHealthcare	$1,216 - $5,753	499%
Aetna	$1,275 - $5,468	523%
Blue Cross Blue Shield	$1,275 - $2,550	523%
Good Samaritan Mcr Adv - All Plans	$1,275 - $2,550	523%
Medica Mcr Adv	$1,275 - $2,550	523%
Va Ccn - All Plans	$1,275 - $2,550	523%
Wellcare Mcr Adv - All Plans	$1,275 - $2,550	523%
Molina Mcaid - All Plans	$1,305 - $2,610	535%
Three Rivers - All Plans	$1,530 - $3,060	628%
6 Degrees Hlth - All Plans	$2,373 - $4,745	973%
Partners Hlth Alliance - All Plans	$2,373 - $4,745	973%
Cpi Benefit Group-All Plans	$2,669 - $5,338	1095%
Providrs Care/Wppa - All Plans	$2,669 - $5,338	1095%
Provider Network Of American - All Plans	$2,758 - $5,516	1131%
Medica-All Other Plans	$2,788 - $5,575	1144%
Chi Health Partners - All Plans	$2,818 - $5,634	1156%
Midwest Ntwrk Alliance - All Plans	$2,818 - $5,634	1156%
First Health - All Plans	$2,821 - $5,640	1157%
Ambetter / Centene	$3,316 - $6,631	1360%

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 $4,004.
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 Phelps Memorial Health 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.