CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Marshfield Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,137
Cash Discount Price: $2,222
vs. Medicare Baseline: 8.77x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Marshfield Medical Center is $2,137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,222. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.77x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$2,222

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,137

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: $2,222 (912%)

Insurance Median: $2,137 (877%)

Cash: $2,222 (912% of Medicare)

Ins. Median: $2,137 (877% 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 877% of the Medicare baseline (a markup of 777%). 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
Blue Cross Blue Shield	$989 - $1,121	406%
Family Health Center (Fhc)	$1,170	480%
Amish/Mennonite	$1,286	528%
Sanford Health Plan	$1,286	528%
UnitedHealthcare	$1,329	545%
Security Health Plan (Shp)	$1,568 - $2,307	643%
The Alliance	$1,626 - $1,953	667%
Group Health Cooperative Of Eau Claire	$1,918 - $2,152	787%
Besse Forest Products	$1,988	816%
Molina Healthcare Of Wi	$1,988	816%
Rice Lake School District	$1,988	816%
Wps Health Insurance	$2,063 - $2,257	846%
Trilogy	$2,105 - $2,245	864%
Medica Of Wi	$2,171 - $2,215	891%
Cigna	$2,199	902%
Healtheos By Multiplan Inc.	$2,199 - $2,222	902%
Corvel	$2,222	912%
First Health	$2,222	912%
Health Partners	$2,222	912%
Three Rivers Provider Network (Trpn)	$2,222	912%
Coventry	$2,245	921%
Health Smart	$2,245	921%
Rising Medical Work Comp	$2,269	931%

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 $2,222.
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 Marshfield Medical Center 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.