CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Charleston Area Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $3,554
Cash Discount Price: $4,250
vs. Medicare Baseline: 14.58x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Charleston Area Medical Center is $3,554. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,250. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 14.58x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$4,250

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,554

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: $4,250 (1743%)

Insurance Median: $3,554 (1458%)

Cash: $4,250 (1743% of Medicare)

Ins. Median: $3,554 (1458% 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 1458% of the Medicare baseline (a markup of 1358%). 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
Aetna	$109 - $4,520	45%
The Health Plan Of West Virginia Inc.	$109 - $4,474	45%
Unicare Health Plan Of West Virginia Inc.	$109	45%
Triwest Va	$236	97%
Blue Cross Blue Shield	$244 - $4,206	100%
Choicecare Network	$244 - $4,520	100%
Optimum Choice Inc.	$244	100%
UnitedHealthcare	$251 - $4,520	103%
West Virginia Senior Advantage Inc.	$256	105%
Integrated Medical Solutions	$475	195%
Naphcare	$488	200%
Caresource	$609	250%
Tricare	$2,198 - $2,767	902%
City Of Charleston	$2,748 - $3,459	1127%
Cigna	$3,408 - $4,289	1398%
Three Rivers Providers Network	$3,554 - $4,474	1458%
Healthsmart	$3,591 - $4,520	1473%
Multiplan	$3,591 - $4,520	1473%

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 $4,250.
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 Charleston Area 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.