CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Primary Children's Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,216
  • Cash Discount Price: $1,284
  • vs. Medicare Baseline: 4.99x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Primary Children's Hospital is $1,216. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,284. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.99x the Medicare baseline. Located in 100 North Mario Capecchi Drive, Salt Lake City, UT.
Cash / Self-Pay
$1,284

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,216

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: $1,284 (527%)
Insurance Median: $1,216 (499%)
Cash: $1,284 (527% of Medicare)
Ins. Median: $1,216 (499% 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 499% of the Medicare baseline (a markup of 399%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
American Health $63 - $976 26%
Health Plan Of Nevada $63 - $201 26%
Healthy U $63 - $201 26%
Molina $63 - $1,439 26%
Selecthealth $63 - $1,439 26%
Southwest Behavioral Health $63 - $223 26%
UnitedHealthcare $63 - $1,439 26%
Tricare $232 95%
Triwest $232 95%
Donor Connect $617 - $682 253%
Aetna $1,216 - $1,456 499%
Awh Connected $1,216 - $1,456 499%
Byu Athletics $1,216 - $1,439 499%
Campbell Scientific $1,216 - $1,439 499%
Cigna $1,216 - $1,439 499%
Deseret Mutual $1,216 - $1,439 499%
Emi $1,216 - $1,439 499%
Emi Health $1,216 - $1,439 499%
First Choice $1,216 - $1,439 499%
First Choice Of The Midwest $1,216 - $1,439 499%
Franklin County $1,216 - $1,439 499%
Global Excel $1,216 - $1,439 499%
Health Utah $1,216 - $1,439 499%
Humana $1,216 - $1,439 499%
Hygeia Corporation $1,216 - $1,439 499%
Ifit $1,216 - $1,439 499%
Juniper Systems $1,216 - $1,439 499%
Lw Miller $1,216 - $1,439 499%
Managed Care Admin $1,216 - $1,439 499%
Medcare International $1,216 - $1,439 499%
Motivhealth $1,216 - $1,439 499%
Pehp $1,216 - $1,439 499%
Prodegi Corp Benefit $1,216 - $1,439 499%
Tanner Llc $1,216 - $1,439 499%
Uofu $1,216 - $1,439 499%
Utah Tech $1,216 - $1,439 499%
Wise Network $1,216 - $1,439 499%
First Health $1,233 - $1,456 506%
Blue Cross Blue Shield $1,250 - $1,473 513%
Springtide $1,250 - $1,473 513%
Utah Behavioral Health Network $1,387 569%
Altius Mhnet Behavioral Health $1,507 618%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 North Mario Capecchi Drive, Salt Lake City, UT 84113
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens