CMS Price Transparency Data

MRI, knee or other leg joint

Facility: CHI St Lukes Lakeside Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,015
Cash Discount Price: $2,726
vs. Medicare Baseline: 4.16x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at CHI St Lukes Lakeside Hospital is $1,015. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,726. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.16x the Medicare baseline. Located in 17400 St Lukes Way, The Woodlands, TX.

Cash / Self-Pay

$2,726

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,015

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: $2,726 (1118%)

Insurance Median: $1,015 (416%)

Cash: $2,726 (1118% of Medicare)

Ins. Median: $1,015 (416% 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 416% of the Medicare baseline (a markup of 316%). 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
Renaissance	$174	71%
Wellpoint	$209 - $363	86%
UnitedHealthcare	$213 - $6,434	87%
United	$215 - $3,660	88%
Blue Cross Blue Shield	$219 - $1,014	90%
Chc	$242 - $4,283	99%
Cigna	$242 - $5,452	99%
Humana	$242 - $5,062	99%
Kelsey	$242	99%
Selectcare	$242	99%
Aetna	$247 - $5,296	101%
Amerivantage	$249	102%
Devoted	$259	106%
Scanhealth	$259	106%
Kindred	$266	109%
Kelseycare	$327 - $1,399	134%
Ambetter / Centene	$363	149%
Community Health Choice	$363	149%
Harris Health	$363	149%
Bright Health	$385	158%
Tchp	$623 - $835	256%
Nx Health	$787	323%
Tchpchip	$2,726 - $3,427	1118%
Texastruechoice	$4,283	1757%
Coventry	$5,062	2077%
First Health	$5,062	2077%
Healthsmart	$5,452	2237%
Interlink	$5,452	2237%
Multiplan	$5,841	2396%
USA Health Network	$6,620	2716%
Mhealth Network	$7,788	3195%

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 $2,726.
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 CHI St Lukes Lakeside 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.