CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Prisma Health Baptist

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,133
  • Cash Discount Price: $2,239
  • vs. Medicare Baseline: 4.65x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Prisma Health Baptist is $1,133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,239. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.65x the Medicare baseline. Located in 1330 Taylor at Marion St, Columbia, SC.
Cash / Self-Pay
$2,239

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,133

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: $2,239 (918%)
Insurance Median: $1,133 (465%)
Cash: $2,239 (918% of Medicare)
Ins. Median: $1,133 (465% 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 465% of the Medicare baseline (a markup of 365%). 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
Tricare $224 92%
Blue Cross Blue Shield $230 - $1,976 94%
Cigna $230 - $2,688 94%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $230 94%
Humana $230 - $2,583 94%
Medicare (plans) $230 - $241 94%
Triwest Healthcare Alliance Vcp [902] $230 94%
Va Community Care Network-Vaccn [903] $230 94%
UnitedHealthcare $237 - $3,365 97%
Aetna $241 - $2,721 99%
Healthy Conn Prime-First Choice Vip Care [5300] $241 99%
Healthy Conn Prime-Molina Healthcare [5330] $241 99%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $241 99%
Workers Comp [600] $321 132%
Ambetter / Centene $422 173%
Medicaid / KanCare $530 - $1,071 217%
Scdc-Sc Dept Of Corrections [7232] $622 255%
Prisma Health Seniorcare Pace - Midlands [5400] $799 328%
Prisma Health Seniorcare Pace-Upstate [5200] $799 328%
Bob Jones Univ-Pai [821] $1,195 490%
Promise Health Plan Contracted [2401] $1,205 - $2,150 494%
Bluechoice [810] $1,268 - $1,971 520%
Orangeburg Senior Helping Center Pace [5401] $1,378 565%
Golden Rule Insurance Company [2991] $1,525 - $3,365 626%
Oxford Health Plans [2992] $1,525 - $3,365 626%
Zzumr-Salt Lake City Ut [3169] $1,525 - $3,365 626%
Planned Administrators [820] $1,976 811%
Meritain Health Contracted [2200] $2,204 - $2,721 904%
Preferred Administrators Contracted [2839] $2,411 989%
Medcost [2940] $2,549 - $2,859 1046%
Atlantic Packaging Contracted [4833] $2,583 1060%
Evernorth Behavioral Contracted [2982] $2,688 1103%
Nippon [2300] $2,721 1116%
Aps Healthcare System [2981] $2,755 1130%
Multiplan/Phcs Contracted [2950] $3,065 1257%
Vsp Vision Care [2986] $3,100 1272%
First Health Contracted [2952] $3,203 1314%
Furman Int/Allen University Student [2951] $3,203 1314%
Quiktrip-First Health [3067] $3,203 1314%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1330 Taylor at Marion St, Columbia, SC 29220
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals