CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Fort Memorial Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $202
Cash Discount Price: $670
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Fort Memorial Hospital is $202. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $670. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.83x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.

Cash / Self-Pay

$670

Average discount available for prompt cash payment at this facility.

Insurance Median

$202

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: $670 (275%)

Insurance Median: $202 (83%)

Cash: $670 (275% of Medicare)

Ins. Median: $202 (83% 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.

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	$41 - $1,434	17%
Dean Health Plan	$49 - $2,420	20%
Quartz	$49 - $2,614	20%
UnitedHealthcare	$50 - $2,801	21%
Molina	$51 - $233	21%
Managed Health Services	$53 - $108	22%
Mercycare	$58 - $2,751	24%
Humana	$60 - $2,637	25%
Medicaid / KanCare	$99	41%
Aetna	$150 - $2,771	62%
Alliance	$166 - $2,652	68%
Fort Care	$202 - $676	83%
Centivo	$216 - $1,000	89%
Medicare (plans)	$233	96%
Group Health Cooperative	$270 - $2,390	111%
Veteran Evaluation Services	$284	117%
Trilogy	$392 - $3,249	161%
Cigna	$423 - $3,511	174%

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 $670.
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 Fort Memorial 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.