CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Sanford Vermillion Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,901
Cash Discount Price: $3,292
vs. Medicare Baseline: 11.90x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Sanford Vermillion Medical Center is $2,901. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,292. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.90x the Medicare baseline. Located in 20 South Plum Street, Vermillion, SD.

Cash / Self-Pay

$3,292

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,901

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: $3,292 (1350%)

Insurance Median: $2,901 (1190%)

Cash: $3,292 (1350% of Medicare)

Ins. Median: $2,901 (1190% 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 1190% of the Medicare baseline (a markup of 1090%). 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	$1,214	498%
Wellmark Sd	$1,251	513%
Ucare	$1,341 - $3,615	550%
Aetna	$1,358 - $3,576	557%
Health Partners	$1,358 - $3,086	557%
Medicare (plans)	$1,358	557%
UnitedHealthcare	$1,358 - $3,436	557%
Primewest	$1,383	567%
Sanford Health Plan	$1,629 - $2,185	668%
Security Health Plan	$2,263	928%
Medica	$3,395 - $3,629	1393%
Wellmark	$3,539 - $3,580	1452%
First Choice Health Network	$3,704	1519%
Healthez	$3,704	1519%
Multiplan	$3,704	1519%

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 $3,292.
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 Vermillion 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.