CMS Price Transparency Data

MRI, knee or other leg joint

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $2,839
  • Cash Discount Price: $3,930
  • vs. Medicare Baseline: 11.65x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at University of Wi Hospitals & Clinics Authority is $2,839. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,930. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.65x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.
Cash / Self-Pay
$3,930

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,839

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: $3,930 (1612%)
Insurance Median: $2,839 (1165%)
Cash: $3,930 (1612% of Medicare)
Ins. Median: $2,839 (1165% 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 1165% of the Medicare baseline (a markup of 1065%). 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
Aetna $244 - $7,005 100%
Blue Cross Blue Shield $244 - $8,297 100%
Humana $244 - $366 100%
Medicare (plans) $244 - $373 100%
UnitedHealthcare $244 - $5,467 100%
Alliance_Premier_Network $2,086 - $4,172 856%
Mercycare $2,166 - $4,332 889%
Triology $2,227 - $5,328 914%
Security_Health_Plan $2,358 - $5,546 967%
Employer'S_Coalition_On_Health $2,402 - $6,725 985%
Alliance $2,456 - $4,912 1008%
Hfn $2,489 - $6,725 1021%
United_Healthcare $2,502 - $7,415 1026%
Beloit_Health_System $2,533 - $5,066 1039%
Aspirus_Health_Plan $2,550 - $5,101 1046%
Cigna $2,620 - $5,240 1075%
Health_Partners_Insurance $2,664 - $5,328 1093%
Health_Payment_Systems $2,677 - $5,353 1098%
Dean_Health_Plan $2,795 - $5,590 1147%
Medical_Associates $2,882 - $5,764 1182%
Wps $3,026 - $6,664 1241%
Employers_Healthcare_Coalition_Of_Wi $3,057 - $6,114 1254%
Aspirus_Network_Inc $3,363 - $6,725 1380%
Chorus_Community $3,494 - $6,987 1433%
Ghc_Eau_Claire_Health_Plan $3,494 - $6,987 1433%
Multiplan $3,494 - $8,035 1433%
Sheybogan_Employers_Health_Network $3,494 - $6,987 1433%
Coventry $3,712 - $7,424 1523%
Dean_Care $3,712 - $7,424 1523%
Healthsmart $3,843 - $7,686 1576%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Highland Avenue, Madison, WI 53792
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals