CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Matagorda Regional Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $956
Cash Discount Price: $854
vs. Medicare Baseline: 3.92x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Matagorda Regional Medical Center is $956. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $854. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.92x the Medicare baseline. Located in 104 7Th Street, Bay City, TX.

Cash / Self-Pay

$854

Average discount available for prompt cash payment at this facility.

Insurance Median

$956

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: $854 (350%)

Insurance Median: $956 (392%)

Cash: $854 (350% of Medicare)

Ins. Median: $956 (392% 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 392% of the Medicare baseline (a markup of 292%). 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
Aetna	$240 - $1,070	98%
Humana	$240 - $788	98%
Medicare (plans)	$240	98%
Triwest	$240	98%
United	$240	98%
Wellcare	$240	98%
UnitedHealthcare	$264 - $956	108%
Am Better	$288	118%
Alliance	$336	138%
Corvel	$479	196%
Cigna	$700	287%
Coventry First Health	$750	308%
Blue Cross Blue Shield	$860 - $1,210	353%
Comm Care	$956	392%
Medicaid / KanCare	$956	392%
Molina	$956	392%
Scott & White	$956	392%
Superior	$956	392%
Tcstar	$956	392%
Wellpoint	$956	392%
Galaxy Health	$1,195	490%
Independent Medical System	$1,451	595%
Multiplan Phcs	$1,451	595%
Three Rivers	$1,451	595%
Health Smart	$1,536	630%
Usa Managed	$1,536	630%

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 $854.
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 Matagorda Regional 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.