CMS Price Transparency Data
MRI, knee or other leg joint
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 73721 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73721
- Insurance Median: $1,034
- Cash Discount Price: $1,867
- vs. Medicare Baseline: 4.24x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Saint Alphonsus Medical Center Ontario is $1,034. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,867. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.24x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$1,867
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,034
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: $1,867 (766%)
Insurance Median: $1,034 (424%)
Cash: $1,867 (766% of Medicare)
Ins. Median: $1,034 (424% 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 424% of the Medicare baseline (a markup of 324%). 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 |
|---|---|---|
| Medicaid / KanCare | $159 - $1,034 | 65% |
| Selecthealth | $271 - $3,102 | 111% |
| Blue Cross Blue Shield | $278 - $2,930 | 114% |
| Medicare (plans) | $278 - $298 | 114% |
| UnitedHealthcare | $278 - $3,309 | 114% |
| Aetna | $287 - $3,264 | 118% |
| American Health Advantage Of Idaho | $290 | 119% |
| Moda Health | $552 - $3,344 | 226% |
| Healthcare Management Admin | $666 - $1,333 | 273% |
| Ada County Jail Inmate Ins | $689 - $1,034 | 283% |
| Ambetter / Centene | $689 - $1,034 | 283% |
| Amish Mennonite | $689 - $1,034 | 283% |
| Bcccp-Michigan | $689 - $1,034 | 283% |
| Bccp | $689 - $1,034 | 283% |
| Bmc Healthnet | $689 - $1,034 | 283% |
| Breast Grant-Connecticut | $689 - $1,034 | 283% |
| California Health And Wellness | $689 - $1,034 | 283% |
| Cardinal Innovations Lme | $689 - $1,034 | 283% |
| Care Oregon Ohp | $689 - $1,034 | 283% |
| Cencal Health Plan | $689 - $1,034 | 283% |
| Cenpatico | $689 - $1,034 | 283% |
| Centurion Of Idaho | $689 - $1,034 | 283% |
| Chhuny | $689 - $1,034 | 283% |
| Childrens Comm Health Plan | $689 - $1,034 | 283% |
| Childrens Medical Services Title 19 | $689 - $1,034 | 283% |
| Cigna | $689 - $3,240 | 283% |
| Community Benefit Health | $689 - $1,034 | 283% |
| Community Care Behavorial Health | $689 - $1,034 | 283% |
| Community Health Choice | $689 - $1,034 | 283% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $689 - $1,034 | 283% |
| Dean Wi Badgercare | $689 - $1,034 | 283% |
| Delaware First Health | $689 - $1,034 | 283% |
| Delta Dental Nj | $689 - $1,034 | 283% |
| Dph Tb Program | $689 - $1,034 | 283% |
| Dscc | $689 - $1,034 | 283% |
| Eastpointe Lme | $689 - $1,034 | 283% |
| Family Health Network | $689 - $1,034 | 283% |
| Freedom First Healthcare | $689 - $1,034 | 283% |
| Ghc Scw Wi Badgercare | $689 - $1,034 | 283% |
| Harbor Health | $689 - $1,034 | 283% |
| Health Safety Net | $689 - $1,034 | 283% |
| Healthy Blue Ne | $689 - $1,034 | 283% |
| Hennepin Health | $689 - $1,034 | 283% |
| Humana | $689 - $3,033 | 283% |
| Id County Ada | $689 - $1,034 | 283% |
| Id County Canyon | $689 - $1,034 | 283% |
| Id County Cat Fund | $689 - $1,034 | 283% |
| Id County Payette | $689 - $1,034 | 283% |
| Idaho Womens Health Check | $689 - $1,034 | 283% |
| Indiana Breast Cervical Cancer | $689 - $1,034 | 283% |
| Inland Empire Health Plan | $689 - $1,034 | 283% |
| Intercommunity Health Ohp | $689 - $1,034 | 283% |
| Iowa Total Care | $689 - $1,034 | 283% |
| Jai Medical System | $689 - $1,034 | 283% |
| Kern Family Health Plan | $689 - $1,034 | 283% |
| Keystone First | $689 - $1,034 | 283% |
| Keystone First Chip | $689 - $1,034 | 283% |
| La Care Health Plan | $689 - $1,034 | 283% |
| Lakeland Care Inc | $689 - $1,034 | 283% |
| Managed Health Services - Indiana | $689 - $1,034 | 283% |
| Maryland Breast & Cervical Program | $689 - $1,034 | 283% |
| Maryland Healthy Smiles - Scion Dental | $689 - $1,034 | 283% |
| Maryland Physicians Care | $689 - $1,034 | 283% |
| Massachusetts Behavioral Health Partnership | $689 - $1,034 | 283% |
| Mdwise | $689 - $1,034 | 283% |
| Medi-Cal | $689 - $1,034 | 283% |
| Medi-Cal Healthnet | $689 - $1,034 | 283% |
| Medstar Dc Healthy Family | $689 - $1,034 | 283% |
| Medstar Md Health Choice | $689 - $1,034 | 283% |
| Mo Home State Health Plan | $689 - $1,034 | 283% |
| Molina Centennial Care | $689 - $1,034 | 283% |
| Nascentia Health Options | $689 - $1,034 | 283% |
| Nebraska Total Care | $689 - $1,034 | 283% |
| New York Cancer Services Program | $689 - $1,034 | 283% |
| Nextlevel Health | $689 - $1,034 | 283% |
| Oregon Screenwise | $689 - $1,034 | 283% |
| Pace Of Southwest Michigan | $689 - $1,034 | 283% |
| Paramount Advantage | $689 - $1,034 | 283% |
| Parkland Community Health Plan | $689 - $1,034 | 283% |
| Partners Behavioral Lme | $689 - $1,034 | 283% |
| Peach State Healthplan | $689 - $1,034 | 283% |
| Presbyterian Centennial Care | $689 - $1,034 | 283% |
| Prestige Health Choice | $689 - $1,034 | 283% |
| Priority Partners | $689 - $1,034 | 283% |
| Rx 340B Pass Along | $689 - $1,034 | 283% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $689 - $1,034 | 283% |
| Rx Medi-Cal | $689 - $1,034 | 283% |
| Rx Meridian Rx | $689 - $1,034 | 283% |
| Sandhills Center Lme | $689 - $1,034 | 283% |
| Screening For Life | $689 - $1,034 | 283% |
| Sunshine State Health Plan | $689 - $1,034 | 283% |
| Superior Health | $689 - $1,034 | 283% |
| Tenncare | $689 - $1,034 | 283% |
| Texas Children'S Health Plan | $689 - $1,034 | 283% |
| Trillium Community Ohp | $689 - $1,034 | 283% |
| Tufts Health Public Plans | $689 - $1,034 | 283% |
| Vaya Health Lme | $689 - $1,034 | 283% |
| Wellsense Health Plan | $689 - $1,034 | 283% |
| Wi Womens Wellness | $689 - $1,034 | 283% |
| Blue Benefit Administrators Of Massachusetts | $696 - $1,393 | 286% |
| Blue Care Network | $696 - $1,393 | 286% |
| Blue Distinction Transplant | $696 - $1,393 | 286% |
| Blue Shield - Ca | $696 - $1,393 | 286% |
| Blue Shield - Id (Regence) | $696 - $1,393 | 286% |
| Blue Shield - Ny Highmark Northeastern | $696 - $1,393 | 286% |
| Blue Shield - Ny Highmark Western | $696 - $1,393 | 286% |
| Blue Shield - Pa (Highmark) | $696 - $1,393 | 286% |
| Blue Shield - Wa (Regence) | $696 - $1,393 | 286% |
| Webtpa | $750 - $3,102 | 308% |
| Mountain Health Co-Op | $1,379 - $2,068 | 566% |
| Pacificsource Health Plans | $1,379 - $3,240 | 566% |
| Allegiance | $1,746 - $2,620 | 716% |
| Correctional Health Partners | $1,792 - $2,689 | 735% |
| Columbia Health Network | $1,838 - $2,758 | 754% |
| Healthnet | $1,930 - $2,895 | 792% |
| Allied National Global Care | $2,068 - $3,102 | 848% |
| Asrm - Reliance Standard Life Insurance | $2,068 - $3,102 | 848% |
| Christian Care Ministry | $2,068 - $3,102 | 848% |
| Dean Health | $2,068 - $3,102 | 848% |
| Fallon Health | $2,068 - $3,102 | 848% |
| Family Life Insurance Company | $2,068 - $3,102 | 848% |
| First Choice Health | $2,068 - $3,102 | 848% |
| Ghc Scw | $2,068 - $3,102 | 848% |
| International Benefit Administrators | $2,068 - $3,102 | 848% |
| Lifetime Benefit Solutions | $2,068 - $3,102 | 848% |
| Manhattan Life | $2,068 - $3,102 | 848% |
| Pai | $2,068 - $3,102 | 848% |
| Pan-American Life | $2,068 - $3,102 | 848% |
| Paramount Hmo | $2,068 - $3,102 | 848% |
| Phcs | $2,068 - $3,102 | 848% |
| Trinity Health Share | $2,068 - $3,102 | 848% |
| Lifewise | $2,137 - $3,206 | 877% |
| Priority Health | $2,160 - $3,240 | 886% |
| Allied Benefit Systems | $2,176 - $3,264 | 893% |
| Ameriben | $2,176 - $3,264 | 893% |
| Asr Health Benefits | $2,176 - $3,264 | 893% |
| Christian Brother Services | $2,176 - $3,264 | 893% |
| Geha | $2,176 - $3,309 | 893% |
| Healthez | $2,176 - $3,264 | 893% |
| Luminare Health (Detroit) | $2,176 - $3,264 | 893% |
| Rural Carrier Health Benefit Plan | $2,176 - $3,264 | 893% |
| First Health | $2,183 - $3,275 | 896% |
| Medi Share | $2,183 - $3,275 | 896% |
| Providence | $2,183 - $3,275 | 896% |