CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Ohiohealth Morrow County Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,216
Cash Discount Price: $2,097
vs. Medicare Baseline: 4.99x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Ohiohealth Morrow County Hospital is $1,216. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,097. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.99x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.

Cash / Self-Pay

$2,097

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,216

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: $2,097 (860%)

Insurance Median: $1,216 (499%)

Cash: $2,097 (860% of Medicare)

Ins. Median: $1,216 (499% 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 499% of the Medicare baseline (a markup of 399%). 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	$314 - $320	129%
UnitedHealthcare	$314 - $2,642	129%
Blue Cross Blue Shield	$317 - $2,490	130%
Amerihealth Caritas - All Plans	$323	133%
Humana	$323 - $3,000	133%
Molina Exchange - All Other Plans	$518	212%
Medicare (plans)	$1,194 - $1,217	490%
Aetna	$1,216 - $2,774	499%
Caresource Marketplace - All Other Plans	$1,492	612%
Medical Mutual Of Ohio Marketplace	$2,419	992%
Ohiohealthy Network - All Other Plans	$2,419	992%
Ohiohealthy Preferred	$2,419	992%
Medical Mutual Of Ohio Comm - All Other Plans	$2,613	1072%
Medical Mutual Of Ohio - Admin Serv	$2,742	1125%
Phcs - All Plans	$2,968	1218%
Cigna	$3,032	1244%
Multiplan - All Plans	$3,065	1257%
Healthstar Comm - All Plans	$3,097	1270%
Beech Street - All Plans	$3,129	1284%

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 $2,097.
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 Ohiohealth Morrow County Hospital 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.