CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Roane Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $232
Cash Discount Price: $481
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Roane Medical Center is $232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $481. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.95x the Medicare baseline. Located in 8045 Roane Medical Center Drive, Harriman, TN.

Cash / Self-Pay

$481

Average discount available for prompt cash payment at this facility.

Insurance Median

$232

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: $481 (197%)

Insurance Median: $232 (95%)

Cash: $481 (197% of Medicare)

Ins. Median: $232 (95% 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.

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
UnitedHealthcare	$105 - $478	43%
Blue Cross Blue Shield	$188 - $823	77%
Wellpoint	$212 - $232	87%
Farm Bureau	$214	88%
Tricare	$221	91%
Humana	$227	93%
Aetna	$232 - $370	95%
Cigna	$232 - $463	95%
Devoted Health	$232	95%
Wellcare	$232	95%
Ambetter / Centene	$987	405%

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 $481.
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 Roane 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.