CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Wooster Community Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $2,649
  • Cash Discount Price: $3,653
  • vs. Medicare Baseline: 10.87x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Wooster Community Hospital is $2,649. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,653. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.87x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$3,653

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,649

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: $3,653 (1499%)
Insurance Median: $2,649 (1087%)
Cash: $3,653 (1499% of Medicare)
Ins. Median: $2,649 (1087% 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 1087% of the Medicare baseline (a markup of 987%). 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
Buckeye Mcaid-All Other Plans $224 92%
Caresource Mcaid $224 92%
UnitedHealthcare $224 - $3,471 92%
Tricare $226 93%
Molina Mcaid $228 94%
Blue Cross Blue Shield $230 - $3,361 94%
Buckeye Mcare $231 95%
Caresource Mcr Adv $231 95%
Humana $231 - $3,434 95%
Med Mutual Of Oh Mcr $231 95%
Molina Mcr $231 95%
Summacare Mcr $231 95%
The Health Plan Mcr Adv $231 95%
Valor Hp Mcr-All Plans $231 95%
Aetna $235 - $3,653 96%
Amerihealth Mcaid-All Plans $235 96%
Magnipower-All Plans $300 123%
Caresource Exch - All Other Plans $330 135%
Molina Marketplace - All Other Plans $392 161%
Clarity Health - All Plans $450 185%
Med Mutual Of Oh Exchange $1,236 507%
Med Mutual Of Oh Supermed $1,236 507%
Med Mutual Of Oh Trad-All Other Plans $1,236 507%
Cigna $1,786 733%
Aultcare/Primecare Mcr Adv $1,790 734%
Cerco-All Plans $2,557 1049%
Aultcare Wayne County $2,740 1124%
Aultcare/Primetime Exch $2,740 1124%
Rayco-All Plans $2,740 1124%
Christian Health Ministries-All Plans $2,923 1199%
Health Ohio Network Employer $2,923 1199%
Wayne County-All Plans $2,923 1199%
Healthsmart Accel $3,032 1244%
Summacare Preferred Choice $3,032 1244%
Health Ohio Network Ppo-All Other Plans $3,105 1274%
Healthsmart Complete Ppo-All Other Plans $3,105 1274%
Ohio Health Choice Supp $3,105 1274%
Ohio Health Group Hlthy - All Other Plans $3,105 1274%
Health Plan Of Upper Ohio-All Plans $3,218 1320%
The Health Plan Comm - All Other Plans $3,218 1320%
Ohio Health Group Pref $3,251 1334%
Aultcare/Primetime-All Other Plans $3,288 1349%
Healthsmart Ppo $3,324 1364%
Summacare-All Other Plans $3,397 1394%
Ohio Health Choice-All Other Plans $3,434 1409%
Healthsmart Hpo $3,471 1424%
Osu-All Plans $3,471 1424%
Central Benefits-All Plans $3,507 1439%
First Health-All Plans $3,507 1439%
Flora-All Plans $3,507 1439%
Beech Street-All Plans $3,544 1454%
Phcs-All Plans $3,544 1454%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals