CMS Price Transparency Data

MRI, knee or other leg joint

Facility: St Marys Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $268
Cash Discount Price: $6,233
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at St Marys Medical Center is $268. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,233. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.10x the Medicare baseline. Located in 2900 1St Avenue, Huntington, WV.

Cash / Self-Pay

$6,233

Average discount available for prompt cash payment at this facility.

Insurance Median

$268

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: $6,233 (2557%)

Insurance Median: $268 (110%)

Cash: $6,233 (2557% of Medicare)

Ins. Median: $268 (110% 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
The Healthplan	$49 - $136	20%
Unicare	$49 - $136	20%
Aetna	$61 - $7,480	25%
Blue Cross Blue Shield	$61 - $1,689	25%
Humana	$61 - $242	25%
Peak Health	$61 - $7,064	25%
Peia	$61 - $268	25%
UnitedHealthcare	$61 - $7,862	25%
Caresource	$67 - $7,895	27%
Medicare (plans)	$242	99%
Cigna	$3,781 - $7,563	1551%
Firsthealth	$3,948 - $7,895	1620%
Healthsmart	$3,948 - $7,895	1620%
Phcs Multiplan	$3,948 - $7,895	1620%
Zelis Network	$3,948 - $7,895	1620%

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 $6,233.
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 St Marys Medical Center 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.