CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mercy Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $232
Cash Discount Price: $983
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mercy Medical Center is $232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $983. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.95x the Medicare baseline. Located in 1320 Mercy Drive Nw, Canton, OH.

Cash / Self-Pay

$983

Average discount available for prompt cash payment at this facility.

Insurance Median

$232

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: $983 (403%)

Insurance Median: $232 (95%)

Cash: $983 (403% of Medicare)

Ins. Median: $232 (95% 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.

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
Summacare	$39 - $502	16%
Aetna	$60 - $1,513	25%
Blue Cross Blue Shield	$60 - $974	25%
Cigna	$60 - $1,355	25%
Humana	$60 - $223	25%
The Health Plan	$60 - $1,513	25%
United	$60 - $223	25%
Mmo	$62 - $464	25%
Communicare	$63 - $235	26%
Perennial Health	$65 - $241	27%
Zing Health	$66 - $246	27%
Aultcare	$69 - $620	28%
Oscar	$155 - $582	64%
Buckeye	$213	87%
Caresource	$213	87%
Molina	$217	89%
Ohcp	$226 - $735	93%
Amerihealth	$227	93%
Omas	$290 - $756	119%
Phphi	$349 - $908	143%
Gms	$407 - $1,059	167%
Immergrun	$436 - $756	179%
Multiplan	$523 - $1,362	215%
Cc Ehp	$604 - $613	248%
Amish Community Aid Plan	$681 - $756	279%
Ohio Healthy	$817	335%
Php	$908	372%
Medical Benefit Corp	$1,059	434%
Consociate Health	$1,135	466%
Frontpath	$1,362	559%
Managed Care Services	$1,362	559%
Tertiary Care Network	$1,362	559%

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 $983.
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 Mercy Medical 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.