CMS Price Transparency Data

MRI, knee or other leg joint

Facility: OHSU Hospital and Clinics

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $622
Cash Discount Price: $2,331
vs. Medicare Baseline: 2.55x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at OHSU Hospital and Clinics is $622. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,331. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.55x the Medicare baseline. Located in 3181 Sw Sam Jackson Park Road, Portland, OR.

Cash / Self-Pay

$2,331

Average discount available for prompt cash payment at this facility.

Insurance Median

$622

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: $2,331 (956%)

Insurance Median: $622 (255%)

Cash: $2,331 (956% of Medicare)

Ins. Median: $622 (255% 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 255% of the Medicare baseline (a markup of 155%). 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
Care Oregon	$214 - $698	88%
Intercommunity Health Network	$214 - $473	88%
Kaiser Foundation Hospitals	$214 - $1,374	88%
Medicare (plans)	$214 - $946	88%
Pacific Source	$214 - $3,588	88%
Samaritan Health Plan	$264 - $1,478	108%
Humana	$268 - $627	110%
Trillium	$268 - $591	110%
Moda	$281 - $2,843	115%
UnitedHealthcare	$284 - $2,409	117%
Aetna	$289 - $729	119%
Health Net Health Plan Of Oregon, Inc.	$308 - $3,572	126%
Providence Health Plan	$322 - $709	132%
Community Health Plan Of Washington	$375 - $885	154%
Tuality Health	$482 - $1,064	198%
Blue Cross Blue Shield	$798	327%
Cigna	$1,406	577%
Coventry First Health	$1,922 - $3,459	788%
First Choice	$1,941 - $3,494	796%
Molina Exchange	$2,562 - $4,612	1051%

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 $2,331.
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 OHSU Hospital and Clinics 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.