CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Adventist Health Portland

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $830
  • Cash Discount Price: $954
  • vs. Medicare Baseline: 3.40x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Adventist Health Portland is $830. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $954. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.40x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$954

Average discount available for prompt cash payment at this facility.

Insurance Median
$830

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: $954 (391%)
Insurance Median: $830 (340%)
Cash: $954 (391% of Medicare)
Ins. Median: $830 (340% 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 340% of the Medicare baseline (a markup of 240%). 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.

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
Pacific Source Comm - All Plans $185 76%
Ods - All Plans $212 87%
Care Oregon - All Plans $225 92%
Kaiser Mcr Adv $265 109%
Humana $271 - $281 111%
Moda Mcr Adv $281 115%
UnitedHealthcare $281 - $1,789 115%
Healthnet Mcr Adv $305 125%
Ah Employee Health Plan - All Plans $477 196%
Moda Conn Oebb/Syn Pebb $530 217%
Regence Ohsu Plus $550 226%
Moda Affinity - All Other Plans $610 250%
Regence - All Other Plans $611 251%
Healthcare Resources - All Plans $670 275%
Providence Hp - All Plans $676 277%
Kaiser - All Other Plans $692 284%
Moda Select $830 340%
Regence Preferred Mcr Adv $834 342%
Moda Connexus $939 385%
Moda Synergy $993 407%
Workers Comp $1,031 423%
Regence Mcr Adv $1,054 432%
Bc Premera First - All Plans $1,490 611%
Worldventure - All Plans $1,789 734%
First Choice - All Plans $2,066 848%
Cigna $2,100 861%
Multiplan - All Plans $2,236 917%
Phcs - All Plans $2,236 917%
Aetna $2,331 956%
First Health-Coventry - All Plans $2,385 978%
National Provider Network - All Plans $2,623 1076%
Health Payors Organization Ltd- All Plans $2,683 1101%
Moda Ohsu Ppo/Epo/Hmc $5,366 2201%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals