CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Adena Fayette Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,689
Cash Discount Price: $2,116
vs. Medicare Baseline: 11.03x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Adena Fayette Medical Center is $2,689. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,116. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.03x the Medicare baseline. Located in 1430 Columbus Avenue, Washington Ch, OH.

Cash / Self-Pay

$2,116

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,689

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: $2,116 (868%)

Insurance Median: $2,689 (1103%)

Cash: $2,116 (868% of Medicare)

Ins. Median: $2,689 (1103% 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 1103% of the Medicare baseline (a markup of 1003%). 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
Blue Cross Blue Shield	$1,439 - $2,806	590%
Aetna	$1,735 - $3,352	712%
Buckeye Community Health Plan	$1,735	712%
Humana	$1,735	712%
Medical Mutual Of Ohio	$1,735 - $3,189	712%
Medigold	$1,735	712%
Molina	$1,735	712%
Care Source	$1,770	726%
Molina Marketplace	$1,909	783%
First Health	$2,000 - $3,318	820%
United Medical Resources Ohcp	$2,662	1092%
UnitedHealthcare	$2,662 - $2,687	1092%
Cigna	$2,916	1196%
Ohio Ppo Connect	$2,962	1215%
The Health Plan	$2,962	1215%
Care Source Just4Me	$3,123	1281%
Medical Mutual Of Ohio Supermed	$3,189	1308%
Ohio Health Choice	$3,369	1382%
Multiplan/Private Healthcare Systems	$4,020	1649%
Sidecar Health	$4,782	1962%

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 $2,116.
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 Adena Fayette 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.