CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Upland Hills Health

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,130
Cash Discount Price: $1,267
vs. Medicare Baseline: 4.64x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Upland Hills Health is $1,130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,267. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.64x the Medicare baseline. Located in 800 Compassion Way, Dodgeville, WI.

Cash / Self-Pay

$1,267

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,130

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: $1,267 (520%)

Insurance Median: $1,130 (464%)

Cash: $1,267 (520% of Medicare)

Ins. Median: $1,130 (464% 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 464% of the Medicare baseline (a markup of 364%). 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
Dean Health Plan	$114 - $2,806	47%
UnitedHealthcare	$123 - $847	50%
Alliance	$157 - $2,281	64%
Ghc Of Eau Claire	$324	133%
Ghc Of Sc Wi	$324 - $2,744	133%
Mhs	$324 - $1,130	133%
Blue Cross Blue Shield	$1,130 - $3,308	464%
Humana	$1,130 - $3,631	464%
Icare	$1,130	464%
Medical Associates	$1,130 - $1,281	464%
Security Health Plan	$1,130	464%
Quartz	$2,084	855%
Wps	$2,461 - $2,538	1010%
Cigna	$3,010 - $3,365	1235%
Multiplan	$3,550	1456%

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 $1,267.
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 Upland Hills Health 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.