CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Othello Community Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $2,349
  • Cash Discount Price: $2,202
  • vs. Medicare Baseline: 9.64x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Othello Community Hospital is $2,349. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,202. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.64x the Medicare baseline. Located in 315 North 14Th Avenue, Othello, WA.
Cash / Self-Pay
$2,202

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,349

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: $2,202 (903%)
Insurance Median: $2,349 (964%)
Cash: $2,202 (903% of Medicare)
Ins. Median: $2,349 (964% 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 964% of the Medicare baseline (a markup of 864%). 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
Ambetter / Centene $1,248 - $1,263 512%
Amerigroup Mcaid $1,248 512%
Chp Mcaid $1,248 512%
Cocare - All Plans $1,248 512%
Gau - All Plans $1,248 512%
Kaiser - All Plans $1,248 512%
Molina Mcaid $1,248 512%
UnitedHealthcare $1,248 - $2,936 512%
Chp - All Other Plans $1,263 518%
Molina - All Other Plans $1,263 518%
Medicare (plans) $1,468 602%
Tricare $1,909 783%
Triwest - All Plans $1,909 783%
Asuris - All Plans $2,349 964%
Commercial Other - All Plans $2,349 964%
Hma - All Plans $2,349 964%
Hmso - All Plans $2,349 964%
Tpsc - All Plans $2,349 964%
Travelers - All Plans $2,349 964%
Veterans Admin - All Plans $2,349 964%
Blue Cross Blue Shield $2,466 1012%
Cigna $2,613 1072%
First Choice - All Plans $2,643 1084%
Aetna $2,760 1132%
Chp Mcr Adv $2,936 1204%
Health Alliance Mcr Adv - All Plans $2,936 1204%
Humana $2,936 1204%
Molina Mcare $2,936 1204%
Wellcare Mcr Adv - All Plans $2,936 1204%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 North 14Th Avenue, Othello, WA 99344
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals