CMS Price Transparency Data
MRI, knee or other leg joint
Facility: Mount Carmel New Albany Surgical Hospital
Billing Code: 73721 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73721
- Insurance Median: $1,330
- Cash Discount Price: $1,543
- vs. Medicare Baseline: 5.46x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mount Carmel New Albany Surgical Hospital is $1,330. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,543. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.46x the Medicare baseline. Located in 7333 Smith's Mill Road, New Albany, OH.
Cash / Self-Pay
$1,543
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,330
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: $1,543 (633%)
Insurance Median: $1,330 (546%)
Cash: $1,543 (633% of Medicare)
Ins. Median: $1,330 (546% 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 546% of the Medicare baseline (a markup of 446%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $202 - $242 | 83% |
| Aetna | $225 - $2,849 | 92% |
| Blue Cross Blue Shield | $225 - $2,849 | 92% |
| Hospice Mount Carmel | $230 | 94% |
| Oscar | $230 | 94% |
| UnitedHealthcare | $230 - $1,904 | 94% |
| The Health Plan | $235 - $1,872 | 96% |
| Enterprise Group Planning | $444 | 182% |
| Custom Design Benefits | $481 | 197% |
| Quality Care Partners | $520 | 213% |
| Medical Mutual | $565 - $2,260 | 232% |
| Crime Victim Assistance | $632 | 259% |
| Ohio Safe Program | $632 | 259% |
| Western & Southern Financial Group | $819 | 336% |
| Geha | $853 - $1,904 | 350% |
| Gravie Admin Services | $853 - $1,279 | 350% |
| Healthez | $853 - $1,279 | 350% |
| Meritain | $853 - $1,279 | 350% |
| Webtpa | $853 - $1,279 | 350% |
| Blue Benefit Administrators Of Massachusetts | $858 | 352% |
| Blue Care Network | $858 | 352% |
| Blue Distinction Transplant | $858 | 352% |
| Blue Shield - Ca | $858 | 352% |
| Blue Shield - Id (Regence) | $858 | 352% |
| Blue Shield - Ny Highmark Northeastern | $858 | 352% |
| Blue Shield - Ny Highmark Western | $858 | 352% |
| Blue Shield - Pa (Highmark) | $858 | 352% |
| Blue Shield - Wa (Regence) | $858 | 352% |
| Access Health | $887 - $1,330 | 364% |
| Acclaim | $887 - $1,330 | 364% |
| Administrative Concepts | $887 - $1,330 | 364% |
| Allegeant | $887 - $1,330 | 364% |
| Allied Benefit Systems | $887 - $1,330 | 364% |
| American Family | $887 - $1,330 | 364% |
| American Healthcare Alliance | $887 - $1,330 | 364% |
| American National | $887 - $1,330 | 364% |
| American Republic | $887 - $1,330 | 364% |
| Amerihealth | $887 - $1,330 | 364% |
| Aultcare | $887 - $1,330 | 364% |
| Automated Benefit Services | $887 - $1,330 | 364% |
| Auxiant | $887 - $1,330 | 364% |
| Benefit Administrative Systems,Llc | $887 - $1,330 | 364% |
| Boon Chapman | $887 - $1,330 | 364% |
| Cam Administrative Services | $887 - $1,330 | 364% |
| Christian Brother Services | $887 - $1,330 | 364% |
| Christian Brothers Holy Cross | $887 - $1,330 | 364% |
| Claimchoice Adminstrators | $887 - $1,330 | 364% |
| Comprehensive Benefits | $887 - $1,330 | 364% |
| Continental Life Insurance | $887 - $1,330 | 364% |
| Coventry | $887 - $1,330 | 364% |
| Custom Benefit Administrators | $887 - $1,330 | 364% |
| Cypress Benefit Administrators | $887 - $1,330 | 364% |
| Employee Benefit Concepts | $887 - $1,330 | 364% |
| Employee Benefit Management | $887 - $1,330 | 364% |
| Forest County Potawatomi | $887 - $1,330 | 364% |
| Freedom Life Insurance Company | $887 - $1,330 | 364% |
| Group Administrators | $887 - $1,330 | 364% |
| Group Marketing Services | $887 - $1,330 | 364% |
| Group Pension Administrators | $887 - $1,330 | 364% |
| Guardian | $887 - $1,330 | 364% |
| Health America | $887 - $1,330 | 364% |
| Health Choices | $887 - $1,330 | 364% |
| Healthcare Management Admin | $887 - $1,330 | 364% |
| Insight | $887 - $1,330 | 364% |
| Intercare | $887 - $1,330 | 364% |
| Jfp Benefit Management | $887 - $1,330 | 364% |
| Jp Farley Corporation | $887 - $1,330 | 364% |
| Key Benefit Administrator | $887 - $1,330 | 364% |
| Liberty Union Life Assurance Co | $887 - $1,330 | 364% |
| Lucent Health | $887 - $1,330 | 364% |
| Luminare Health | $887 - $1,330 | 364% |
| Magnacare | $887 - $1,330 | 364% |
| Medcost | $887 - $1,330 | 364% |
| Mutual Health Services | $887 - $1,330 | 364% |
| Mutual Of Omaha | $887 - $1,330 | 364% |
| Ncas | $887 - $1,330 | 364% |
| Nippon Life Ins | $887 - $1,330 | 364% |
| Nova | $887 - $1,330 | 364% |
| Painters Union Insurance Fund | $887 - $1,330 | 364% |
| Physicians Mutual | $887 - $1,330 | 364% |
| Plumbers Local 98 Insurance Fund | $887 - $1,330 | 364% |
| Prairie States | $887 - $1,330 | 364% |
| Preferred One | $887 - $1,330 | 364% |
| Primary Physician Care | $887 - $1,330 | 364% |
| Professional Benefit Administrators | $887 - $1,330 | 364% |
| Secureone Preferred United Plans | $887 - $1,330 | 364% |
| Siho Insurance Services | $887 - $1,330 | 364% |
| Sisco Benefits | $887 - $1,330 | 364% |
| The Loomis Company | $887 - $1,330 | 364% |
| Trustmark Small Business Benefits | $887 - $1,330 | 364% |
| U Of M Health Plan | $887 - $1,330 | 364% |
| Unicare | $887 - $1,330 | 364% |
| Unified Group Services | $887 - $1,330 | 364% |
| Us Health And Life | $887 - $1,330 | 364% |
| Valenz | $887 - $1,330 | 364% |
| Varipro | $887 - $1,330 | 364% |
| Wps | $887 - $1,330 | 364% |
| Humana | $971 - $2,849 | 398% |
| First Health | $1,001 - $1,501 | 411% |
| Medben | $1,139 - $2,137 | 467% |
| Consociate | $1,160 - $1,741 | 476% |
| Health Ohio Network | $1,160 - $1,741 | 476% |
| Caresource | $1,386 - $2,080 | 569% |
| Healthlink Inc | $1,424 - $2,137 | 584% |
| Medical Benefits Mutual | $1,424 - $2,137 | 584% |
| Ohio Health Choice | $1,424 - $2,137 | 584% |
| Ohio Ppo Connect | $1,424 - $2,137 | 584% |
| Medi Share | $1,517 - $2,276 | 622% |
| Multiplan | $1,517 - $2,276 | 622% |
| Phcs | $1,517 - $2,276 | 622% |
| Philadelphia American Life Insurance | $1,517 - $2,276 | 622% |
| Ameriben | $1,519 - $2,279 | 623% |
| Luminare Health (Detroit) | $1,519 - $2,279 | 623% |
| Ohiohealthy | $1,519 - $2,279 | 623% |
| Osu Not Independent Choice | $1,519 - $2,279 | 623% |
| Twin Valley Psychiatric | $1,519 - $2,279 | 623% |
| Health Smart | $1,614 - $2,422 | 662% |
| Rural Carrier Health Benefit Plan | $1,776 | 729% |
| American Postal Workers Secondary | $1,875 | 769% |
| Cigna | $1,875 | 769% |
| Health Partners | $1,875 | 769% |
| Healthgram | $1,875 | 769% |
| Mvp | $1,875 | 769% |
| Priority Health | $1,875 | 769% |
| Bccp | $1,899 - $2,849 | 779% |
| Medicaid / KanCare | $1,899 - $2,849 | 779% |
| Optima Health | $1,899 - $2,849 | 779% |