CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Astria Sunnyside Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,773
Cash Discount Price: $2,561
vs. Medicare Baseline: 7.27x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Astria Sunnyside Hospital is $1,773. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,561. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.27x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$2,561

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,773

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: $2,561 (1051%)

Insurance Median: $1,773 (727%)

Cash: $2,561 (1051% of Medicare)

Ins. Median: $1,773 (727% 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 727% of the Medicare baseline (a markup of 627%). 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)	$246 - $1,523	101%
Medicaid / KanCare	$565 - $1,848	232%
Aetna	$725 - $5,306	297%
Healthcomp_Ihs	$725 - $1,479	297%
Humana	$725 - $5,427	297%
Molina	$725 - $1,479	297%
Va	$725 - $1,479	297%
Tricare	$732 - $1,494	300%
Regence	$1,519 - $3,099	623%
Cigna	$1,773 - $3,618	727%
Li	$1,814 - $3,702	744%
First_Choice	$2,216 - $4,522	909%
Tpsc	$2,305 - $4,703	946%
Kaiser	$2,320 - $4,735	952%
Premera	$2,405 - $4,908	987%
UnitedHealthcare	$2,512 - $5,126	1030%
Fhpw	$2,600 - $5,306	1067%
Healthcomp	$2,660 - $5,427	1091%
Bcchp	$2,955 - $6,030	1212%
Great_Rivers	$2,955 - $6,030	1212%
Zenith	$2,955 - $6,030	1212%

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 $2,561.
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 Astria Sunnyside 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.