CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Carilion Giles Community Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,962
  • Cash Discount Price: $1,349
  • vs. Medicare Baseline: 8.05x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Carilion Giles Community Hospital is $1,962. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,349. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.05x the Medicare baseline. Located in 159 Hartley Way, Pearisburg, VA.
Cash / Self-Pay
$1,349

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,962

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: $1,349 (553%)
Insurance Median: $1,962 (805%)
Cash: $1,349 (553% of Medicare)
Ins. Median: $1,962 (805% 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 805% of the Medicare baseline (a markup of 705%). 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
Blue Cross Blue Shield $186 - $1,230 76%
Sentara Health Plan $190 - $2,390 78%
Abh Of Va (Formerly Coventry) $195 80%
Abh Of Wva (Formerly Coventry) $195 80%
Humana $195 - $227 80%
UnitedHealthcare $195 - $3,151 80%
Aetna $209 - $2,560 86%
Gateway - Tier 3 $2,120 870%
Vhn - Ultra $2,390 980%
Cigna $2,598 - $2,776 1066%
Connecticare $2,698 1107%
Vhn - Plus $2,968 1218%
Gateway - Tier 2 $3,084 1265%
Vhn $3,084 1265%
Vhn - Link $3,470 1423%
Gateway - Tier 1 $3,662 1502%
Vhn - Secondary Payors $3,662 1502%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 159 Hartley Way, Pearisburg, VA 24134
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals