CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Gundersen Moundview Hospital and Clinics

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,764
Cash Discount Price: $1,508
vs. Medicare Baseline: 7.24x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Gundersen Moundview Hospital and Clinics is $1,764. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,508. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.24x the Medicare baseline. Located in 402 W Lake St, Friendship, WI.

Cash / Self-Pay

$1,508

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,764

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: $1,508 (619%)

Insurance Median: $1,764 (724%)

Cash: $1,508 (619% of Medicare)

Ins. Median: $1,764 (724% 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 724% of the Medicare baseline (a markup of 624%). 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
Amerigroup	$103	42%
Blue Cross Blue Shield	$740 - $3,696	304%
Iowa Total Care	$740	304%
Managed Health Service	$740	304%
Dean Health Plan	$1,193	489%
Health Partners	$1,352 - $2,596	555%
Security Health Plan	$1,352	555%
Ucare	$1,352 - $2,352	555%
UnitedHealthcare	$1,591	653%
Quartz	$1,602	657%
Wps	$2,266	930%
Wps - Arise	$2,266	930%
Alliance	$2,352 - $2,793	965%
Aspirus Arise Health	$2,440	1001%
Humana	$2,499	1025%
Multiplan/Healtheos	$2,587 - $2,822	1061%
Coventry Health Care	$2,793	1146%

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 $1,508.
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 Gundersen Moundview Hospital and Clinics 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.