CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Prisma Health North Greenville Ltach

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $561
  • Cash Discount Price: $2,239
  • vs. Medicare Baseline: 2.30x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Prisma Health North Greenville Ltach is $561. 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 2.30x the Medicare baseline. Located in 807 N Main St, Travelers Rest, SC.
Cash / Self-Pay
$2,239

Average discount available for prompt cash payment at this facility.

Insurance Median
$561

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: $561 (230%)
Cash: $2,239 (918% of Medicare)
Ins. Median: $561 (230% 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 230% of the Medicare baseline (a markup of 130%). 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 $225 92%
Blue Cross Blue Shield $229 - $1,682 94%
Champva [3049] $229 94%
Cigna $229 - $2,688 94%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $229 94%
Deseret Mutual Ins Co [3066] $229 94%
Generic Skilled Nursing [3196] $229 94%
Hospice Contracted [1500] $229 94%
Hospice Non Contracted [3190] $229 94%
Medicare (plans) $229 - $545 94%
Triwest Healthcare Alliance Vcp [902] $229 94%
Va Community Care Network-Vaccn [903] $229 94%
Veterans Administration [3194] $229 94%
Humana $233 - $583 96%
UnitedHealthcare $237 - $2,553 97%
Aetna $240 - $2,721 98%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $240 98%
Healthy Conn Prime-First Choice Vip Care [5300] $242 99%
Healthy Conn Prime-Molina Healthcare [5330] $251 103%
Workers Comp [600] $320 131%
Ambetter / Centene $421 173%
Medicaid / KanCare $530 - $572 217%
First Choice Benefits Mgmt [3074] $545 224%
Scdc-Sc Dept Of Corrections [7232] $622 255%
Prisma Health Seniorcare Pace - Midlands [5400] $799 328%
Prisma Health Seniorcare Pace-Upstate [5200] $799 328%
Bluechoice [810] $888 - $1,772 364%
Golden Rule Insurance Company [2991] $1,157 - $2,553 475%
Oxford Health Plans [2992] $1,157 - $2,553 475%
Zzumr-Salt Lake City Ut [3169] $1,157 - $2,553 475%
Bob Jones Univ-Pai [821] $1,195 490%
Promise Health Plan Contracted [2401] $1,205 - $2,150 494%
Orangeburg Senior Helping Center Pace [5401] $1,378 565%
Planned Administrators [820] $1,682 690%
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%
Mvp Health Care [3037] $2,688 1103%
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: 807 N Main St, Travelers Rest, SC 29690
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL