CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Baylor Scott & White Medical Center - Marble Falls

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,711
Cash Discount Price: $1,999
vs. Medicare Baseline: 7.02x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Baylor Scott & White Medical Center - Marble Falls is $1,711. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,999. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.02x the Medicare baseline. Located in 810 W Highway 71, Marble Falls, TX.

Cash / Self-Pay

$1,999

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,711

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: $1,999 (820%)

Insurance Median: $1,711 (702%)

Cash: $1,999 (820% of Medicare)

Ins. Median: $1,711 (702% 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 702% of the Medicare baseline (a markup of 602%). 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
Baylor Scott & White Health Plan	$205 - $1,855	84%
Superior Health Plan	$211 - $216	87%
Humana	$216 - $2,332	89%
Triwest	$216	89%
Corvel	$226	93%
Prime Health Services	$226	93%
American Health Plan	$227	93%
Blue Cross Blue Shield	$227 - $1,114	93%
Healthspring	$227	93%
Procare Advantage	$227	93%
UnitedHealthcare	$248 - $1,921	102%
Sedgwick	$323	133%
Cigna	$1,711 - $2,013	702%
Aetna	$1,833	752%
Midcoast	$1,833	752%
Quiktrip	$1,833	752%
Independent Medical System	$1,999	820%
University Of Mary Hardin-Baylor	$2,014	826%
Curative	$2,166	889%
First Health	$2,332	957%
Healthsmart	$2,332 - $2,499	957%
Bluebell Creameries	$2,499	1025%
Private Health Care System	$2,499	1025%
Three Rivers	$2,999	1230%

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 $1,999.
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 Baylor Scott & White Medical Center - Marble Falls 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.