CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Sanford Chamberlain Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,755
Cash Discount Price: $2,969
vs. Medicare Baseline: 11.30x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Sanford Chamberlain Medical Center is $2,755. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,969. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.30x the Medicare baseline. Located in 300 S Byron, Chamberlain, SD.

Cash / Self-Pay

$2,969

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,755

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: $2,969 (1218%)

Insurance Median: $2,755 (1130%)

Cash: $2,969 (1218% of Medicare)

Ins. Median: $2,755 (1130% 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 1130% of the Medicare baseline (a markup of 1030%). 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
Sanford Health Plan Align	$1,269	521%
Ucare	$1,362 - $3,260	559%
Wellmark Sd	$1,362 - $3,229	559%
Aetna	$1,377 - $3,225	565%
Health Partners	$1,377 - $2,783	565%
Medicare (plans)	$1,377	565%
UnitedHealthcare	$1,377 - $3,099	565%
Primewest	$1,403	576%
Sanford Health Plan	$2,033 - $2,728	834%
Security Health Plan	$2,041	837%
Medica	$3,062 - $3,273	1256%
First Choice Health Network	$3,340	1370%
Healthez	$3,340	1370%
Multiplan	$3,340	1370%

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 $2,969.
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 Sanford Chamberlain Medical Center 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.