MRI, knee or other leg joint
Facility: Oakleaf Surgical Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $236
- Cash Discount Price: $3,970
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $236 - $3,220 | 97% |
| Dean Health Plan | $236 | 97% |
| Group Health Cooperative Of Eau Claire | $236 | 97% |
| Healthpartners | $236 | 97% |
| Humana | $236 | 97% |
| Medica | $236 | 97% |
| Quartz Health Solutions | $236 | 97% |
| Security Health Plan Of Wi | $236 - $876 | 97% |
| Ucare Wi | $236 | 97% |
| UnitedHealthcare | $236 | 97% |
Consumer Guidance & Cost Commentary
For an MRI of the knee or other leg joint at Oakleaf Surgical Hospital in Altoona, Wisconsin, the cash price of $3,970 is significantly lower than the reported gross charge of $4,411 and the Medicare benchmark of $243.77. While the facility's cash rate is higher than the Medicare amount, it remains the most affordable option available in this dataset, particularly for patients with high-deductible plans where the insurance negotiated rate of $236 might exceed their out-of-pocket costs if they have not yet met their deductible. It is important to note that while the cash price appears competitive against the listed gross charge, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to potentially reduce the final amount owed.
The insurance negotiated rates vary by payer, with most plans settling at $236, though Security Health Plan Of Wi has a higher rate of $876. Because the cash price of $3,970 is substantially lower than the highest negotiated rate of $876, paying out-of-pocket may result in significant savings compared to using insurance for this service. Patients should be aware that balance billing is largely prohibited for in-network services under the No Surprises Act, but they must ensure the facility is properly classified as in-network to avoid unexpected charges. Furthermore, if a summary bill is received, consumers should request a full itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through formal written disputes.