CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Tristar Southern Hills Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $796
Cash Discount Price: $8,254
vs. Medicare Baseline: 3.27x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Tristar Southern Hills Medical Center is $796. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,254. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.27x the Medicare baseline. Located in 391 Wallace Rd, Nashville, TN.

Cash / Self-Pay

$8,254

Average discount available for prompt cash payment at this facility.

Insurance Median

$796

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: $8,254 (3386%)

Insurance Median: $796 (327%)

Cash: $8,254 (3386% of Medicare)

Ins. Median: $796 (327% 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 327% of the Medicare baseline (a markup of 227%). 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
Humana	$254 - $2,064	104%
United	$314 - $3,714	129%
Blue Cross Blue Shield	$505 - $844	207%
Aetna	$558 - $4,127	229%
Kentucky Labor Cabinet	$1,520	624%
Apex Health	$1,568	643%
Nhc Advantage, Inc.	$1,568	643%
Pruitt Health (Allyalign)	$1,568	643%
Cigna	$2,691	1104%
Bgfh Singlesource	$4,127 - $7,016	1693%
Multiplan	$4,787	1964%
Employers Health Network	$5,778	2370%
Beech Street	$7,264	2980%
Prime Health	$7,264	2980%

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 $8,254.
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 Tristar Southern Hills 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.