CMS Price Transparency Data

MRI, knee or other leg joint

Facility: El Paso Children's Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $746
Cash Discount Price: $298
vs. Medicare Baseline: 3.06x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at El Paso Children's Hospital is $746. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $298. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.06x the Medicare baseline. Located in 4845 Alameda Avenue, El Paso, TX.

Cash / Self-Pay

$298

Average discount available for prompt cash payment at this facility.

Insurance Median

$746

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: $298 (122%)

Insurance Median: $746 (306%)

Cash: $298 (122% of Medicare)

Ins. Median: $746 (306% 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 306% of the Medicare baseline (a markup of 206%). 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
Uh Military Va	$179	73%
Health Net Fed Svcs	$193	79%
Blue Cross Blue Shield	$199 - $1,502	82%
Amerigroup Tx	$209	86%
Point Comfort Underwriters	$209	86%
Superior	$209	86%
El Paso Health Plans	$230	94%
Molina Tx	$230	94%
El Paso First Health Plan	$272 - $561	112%
Western Sky	$515 - $1,062	211%
UnitedHealthcare	$698 - $1,438	286%
Aetna	$700 - $1,602	287%
Cigna	$763 - $1,572	313%
Coventry Health Care	$778 - $1,602	319%
Fortified Provider Network	$778 - $1,602	319%
Multiplan	$778 - $1,602	319%
Molina Nm	$909	373%

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 $298.
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 El Paso Children's 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.