CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Texas Childrens Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,985
Cash Discount Price: $3,174
vs. Medicare Baseline: 12.25x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Texas Childrens Hospital is $2,985. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,174. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 12.25x the Medicare baseline. Located in 6621 Fannin Street, Houston, TX.

Cash / Self-Pay

$3,174

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,985

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: $3,174 (1302%)

Insurance Median: $2,985 (1225%)

Cash: $3,174 (1302% of Medicare)

Ins. Median: $2,985 (1225% 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 1225% of the Medicare baseline (a markup of 1125%). 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
Superior Chip	$209 - $219	86%
Driscoll Children'S Health Plan Mcd	$230	94%
First Care Health Plan	$1,279 - $3,032	525%
UnitedHealthcare	$1,279 - $3,032	525%
Molina Mcd	$1,421	583%
Blue Cross Blue Shield	$1,658 - $2,985	680%
Community Health Choice	$1,673 - $3,032	686%
Community First Health Plan Mcd	$1,895	777%
Cook Children'S Health Plan	$1,895	777%
Cigna	$2,701 - $3,032	1108%
Aetna	$3,032	1244%
Kelseycare	$3,080	1263%
Healthsmart	$3,317	1361%
Evolutions Healthcare	$3,554	1458%
First Health	$4,169 - $4,501	1710%
Multiplan	$4,264	1749%
Galaxy Health Network	$4,501	1846%

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 $3,174.
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 Texas Childrens Hospital 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.