CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Ascension Seton Edgar B Davis

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $294
Cash Discount Price: $744
vs. Medicare Baseline: 1.21x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Ascension Seton Edgar B Davis is $294. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $744. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.21x the Medicare baseline. Located in 130 Hays Street, Luling, TX.

Cash / Self-Pay

$744

Average discount available for prompt cash payment at this facility.

Insurance Median

$294

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: $744 (305%)

Insurance Median: $294 (121%)

Cash: $744 (305% of Medicare)

Ins. Median: $294 (121% 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
Blue Cross Blue Shield	$176 - $1,042	72%
Champva	$176 - $230	72%
Dell Star	$176 - $290	72%
UnitedHealthcare	$176 - $290	72%
Wellpoint Star	$176 - $290	72%
Wellpoint Star Plus	$176 - $294	72%
Ambetter / Centene	$211 - $224	87%
Wellpoint Chip/Chip Perinate	$211 - $294	87%
Wellpoint Star Kids	$211 - $294	87%
Dell Chip/Chip Perinate	$224 - $294	92%
Tricare	$264	108%
Humana	$282	116%
Seton Performance Plus	$755	310%
Superior Star	$791 - $863	324%
Superior Star Foster	$791 - $863	324%
Superior Star Kids	$791 - $863	324%
Superior Star Plus	$791 - $863	324%
Superior Chip/Chip Perinate	$890 - $971	365%
Aetna	$1,536 - $1,976	630%
Covenant Health	$1,536	630%
Cigna	$1,750	718%

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 $744.
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 Ascension Seton Edgar B Davis 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.