CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Children's Nebraska

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,178
Cash Discount Price: Unavailable
vs. Medicare Baseline: 8.93x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Children's Nebraska is $2,178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.93x the Medicare baseline. Located in 8200 Dodge St, Omaha, NE.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,178

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%)

Insurance Median: $2,178 (893%)

Ins. Median: $2,178 (893% 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 893% of the Medicare baseline (a markup of 793%). 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
Medicaid / KanCare	$296 - $1,337	121%
Wellpoint	$296	121%
Molina (Iowa)	$306	126%
Ambetter / Centene	$488 - $3,018	200%
Molina (Nebraska)	$524	215%
UnitedHealthcare	$960 - $1,067	394%
Midlands Choice Chi	$3,018	1238%
Blue Cross Blue Shield	$3,105 - $3,450	1274%
Midlands Choice Elevate	$3,450	1415%
Avera Health Plan	$3,665	1503%
Centivo	$3,665	1503%
Wellmark	$3,665	1503%
Aetna	$3,795	1557%
Midlands Choice	$3,795	1557%
Sanford Health Plan	$3,795	1557%

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 $X.
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 Children's Nebraska 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.