CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Lafollette Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $503
  • Cash Discount Price: $2,574
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Lafollette Medical Center is $503. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,574. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.06x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
$2,574

Average discount available for prompt cash payment at this facility.

Insurance Median
$503

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: $2,574 (1056%)
Insurance Median: $503 (206%)
Cash: $2,574 (1056% of Medicare)
Ins. Median: $503 (206% 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 206% of the Medicare baseline (a markup of 106%). 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
Medicaid / KanCare $84 - $517 34%
UnitedHealthcare $84 - $10,711 34%
Amerigroup $181 - $432 74%
Tricare $211 - $467 87%
Veterans Eval Services $216 - $432 89%
Node Champva $223 - $491 91%
Triwest $227 - $501 93%
Blue Cross Blue Shield $228 - $1,864 94%
Humana $228 - $2,356 94%
Medicare (plans) $228 - $503 94%
Node Bluecare Plus Tn Mcr Adv $228 - $503 94%
Node Hospice Non Par Agree $232 - $512 95%
Node Va $232 - $512 95%
Node Wellcare Mcr Adv $232 - $512 95%
Node Devoted Health Mcr Adv $233 - $513 96%
Node Farm Bureau Mcr Adv $233 - $513 96%
Aetna $235 - $6,662 96%
Node Blueadvantage Mcr Adv $235 - $518 96%
Node Healthspring Mcr Adv $235 - $518 96%
Node Amerigroup Mcr Adv $240 - $529 98%
Windsor Health Plan $240 - $529 98%
Node Nhc Mcr Adv $251 - $554 103%
Node Us Dept Of Labor $290 - $639 119%
Cigna $317 - $709 130%
Bluecare $344 - $583 141%
Wellcare $345 - $517 142%
Novanet Work Comp Tn $359 - $802 147%
Tn Work Comp $363 - $810 149%
Ambetter / Centene $429 - $946 176%
Node Point Comfort Underwriters $510 - $1,125 209%
Self Pay $1,963 - $3,075 805%
Multiplan Complementary $5,196 - $8,141 2132%
Beech Street Work Comp Tn $36,200 - $79,871 14850%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals