CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Lee County Community Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $654
Cash Discount Price: $599
vs. Medicare Baseline: 2.68x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Lee County Community Hospital is $654. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $599. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.68x the Medicare baseline. Located in 127 Health Care Drive, Pennington Gap, VA.

Cash / Self-Pay

$599

Average discount available for prompt cash payment at this facility.

Insurance Median

$654

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: $599 (246%)

Insurance Median: $654 (268%)

Cash: $599 (246% of Medicare)

Ins. Median: $654 (268% 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 268% of the Medicare baseline (a markup of 168%). 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
UnitedHealthcare	$305 - $2,624	125%
Blue Cross Blue Shield	$436 - $2,624	179%
Optima Health	$436 - $654	179%
Aetna	$453 - $2,624	186%
Molina Healthcare	$453 - $680	186%
Ambetter / Centene	$568 - $577	233%
Amerigroup	$568 - $2,624	233%
Managed Medicaire	$568 - $577	233%
Medicare (plans)	$568 - $577	233%
Mountain Empire Pace	$568 - $577	233%
Sentara Health	$568 - $677	233%
United Mine Workers Of America	$568 - $577	233%
Humana	$577 - $587	237%
Cigna	$596 - $2,624	244%
Devoted Health Plan	$596 - $606	244%
Nhc Advantage	$596 - $606	244%
Seven Corners, Inc.	$1,363 - $1,385	559%
First Health Coventry	$2,581 - $2,624	1059%
Medcost	$2,581 - $2,624	1059%

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 $599.
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 Lee County Community 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.