CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Forks Community Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,643
Cash Discount Price: $2,723
vs. Medicare Baseline: 6.74x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Forks Community Hospital is $1,643. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,723. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.74x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$2,723

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,643

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: $2,723 (1117%)

Insurance Median: $1,643 (674%)

Cash: $2,723 (1117% of Medicare)

Ins. Median: $1,643 (674% 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 674% of the Medicare baseline (a markup of 574%). 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
Medicare (plans)	$318	130%
Medicaid / KanCare	$1,091 - $1,338	448%
Coordinated Care (Mco) Mcd-All Plans	$1,178 - $1,364	483%
UnitedHealthcare	$1,404 - $3,104	576%
Community Health Network Mcr-All Other Plans	$1,420 - $1,643	583%
Humana	$1,420 - $1,643	583%
Tricare	$1,420 - $1,643	583%
Triwest-All Plans	$1,420 - $1,643	583%
Ambetter / Centene	$1,647 - $1,906	676%
Wellcare Med Adv - All Plans	$1,647 - $1,906	676%
Regence-All Other Plans	$1,817 - $2,103	745%
Community Health Exchange	$2,051 - $2,374	841%
Molina Commercial-All Other Plans	$2,903 - $3,360	1191%
Aetna	$2,997 - $3,469	1229%
Blue Cross Blue Shield	$2,997 - $3,469	1229%
Cigna	$3,155 - $3,652	1294%
First Choice-All Plans	$3,155 - $3,652	1294%

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 $2,723.
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 Forks 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.