MRI, knee or other leg joint
Facility: Susan B Allen Memorial Hospital
Billing Code: 73721 (CPT)
- CPT Billing Code: 73721
- Insurance Median: $1,041
- Cash Discount Price: $1,254
- vs. Medicare Baseline: 4.27x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 427% of the Medicare baseline (a markup of 327%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| UnitedHealthcare | $350 | 144% |
| Providrs Care | $1,731 | 710% |
Consumer Guidance & Cost Commentary
For the MRI of the knee or other leg joint (CPT 73721) at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $1,254.00, which is significantly lower than the facility's gross charge of $1,929.00. While the hospital's negotiated rates with UnitedHealthcare ($350) and Providrs Care ($1,731) vary by plan, patients should be aware that commercial negotiated rates often include administrative overhead and can exceed cash prices. In this case, paying cash directly may result in lower out-of-pocket costs compared to using insurance if your deductible has not yet been met, as the cash rate is substantially below the negotiated amounts listed for these payers.
To ensure you are receiving fair value, it is important to compare these rates against the Medicare benchmark, which serves as the objective baseline for hospital pricing. The Medicare amount for this procedure is $243.77, and the facility's cash rate is approximately 5.1 times higher than this federal standard, reflecting the typical markup found in commercial billing. Additionally, you should inquire about "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the costly insurance claims process. Always request an itemized bill before finalizing payment to verify that all charges are accurate and that no unnecessary services have been included.