CMS Price Transparency Data
MRI, knee or other leg joint
Facility: Clovis Community Medical Center
Billing Code: 73721 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73721
- Insurance Median: $219
- Cash Discount Price: $4,500
- vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Clovis Community Medical Center is $219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,500. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.90x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$4,500
Average discount available for prompt cash payment at this facility.
Insurance Median
$219
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: $4,500 (1846%)
Insurance Median: $219 (90%)
Cash: $4,500 (1846% of Medicare)
Ins. Median: $219 (90% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Meritage Blue Shield 65 Plus | $64 - $307 | 26% |
| Blue Shield | $64 - $3,201 | 26% |
| Well Path (Cfmg) | $64 - $6,188 | 26% |
| Generic Bscphp | $64 - $307 | 26% |
| Advantek Table Mountain Rancheria Tribal Member | $64 - $307 | 26% |
| Healthnet HMO - La Salle | $64 - $307 | 26% |
| Todays Pyramid | $64 - $307 | 26% |
| Us Marshal | $64 - $307 | 26% |
| Bscphp - First Choice | $64 - $307 | 26% |
| Healthnet Sante | $64 - $307 | 26% |
| Brand New Day | $64 - $307 | 26% |
| Cigna | $64 - $3,489 | 26% |
| Victims of Crime | $64 - $307 | 26% |
| Generic | $64 - $307 | 26% |
| Care1St HMO - Ehs | $64 - $307 | 26% |
| Blue Shield Promise - Imperial | $64 - $307 | 26% |
| Humana | $64 - $4,219 | 26% |
| Blue Shield Sante | $64 - $307 | 26% |
| Sequoia Pace - Peak Tpa | $64 - $307 | 26% |
| Cares Act Provider Relief Fund | $64 - $307 | 26% |
| Bscphp - Dhmso | $64 - $307 | 26% |
| Healthnet HMO - Cvmp/Medpro | $64 - $307 | 26% |
| Sante Sub Cap-Blue Shield/Sante | $64 - $307 | 26% |
| Medicare (plans) | $64 - $307 | 26% |
| Railroad Part B | $64 - $307 | 26% |
| Blue Shield Hmo-Cvmp/Medpro | $64 - $307 | 26% |
| Railroad Part A | $64 - $307 | 26% |
| Meritage Brand New Day | $64 - $307 | 26% |
| Healthnet HMO - Dhmso | $64 - $307 | 26% |
| Healthnet Sante - Sub Cap Dual Risk | $64 - $307 | 26% |
| Medi-Cal Innovative Integrated Health | $64 - $307 | 26% |
| Generic Victims of Crime | $64 - $307 | 26% |
| Sante Sub Cap Healthnet Seniority | $64 - $307 | 26% |
| Gemcare HMO | $64 - $307 | 26% |
| Blue Shield 65 Plus HMO First Choice | $64 - $307 | 26% |
| Railroad Part A & B | $64 - $307 | 26% |
| Sante-Blue Shield/Sante | $64 - $307 | 26% |
| UnitedHealthcare | $64 - $2,949 | 26% |
| Aetna | $64 - $2,812 | 26% |
| Blue Shield Saint Agnes | $64 - $307 | 26% |
| Meritage Healthnet HMO | $64 - $307 | 26% |
| Healthnet HMO - Sante | $64 - $307 | 26% |
| Wellcare | $64 - $307 | 26% |
| Hartford Life Supplement | $64 - $307 | 26% |
| Healthnet Sante Dual Risk | $64 - $307 | 26% |
| Blue Cross Blue Shield | $64 - $3,577 | 26% |
| Sante | $64 - $307 | 26% |
| Sante-Healthnet Seniority | $64 - $307 | 26% |
| Scan Health Plan | $64 - $307 | 26% |
| Sante-Sub Cap Ma Brand New Day | $64 - $307 | 26% |
| Bscphp HMO - First Choice | $64 - $307 | 26% |
| Blue Shield 65 Plus HMO Ehs | $64 - $307 | 26% |
| Alignment Health Plan | $70 - $338 | 29% |
| Champion Health Plan of California Ma | $70 - $338 | 29% |
| Innovative Integrated Health Community Plans HMO | $70 - $338 | 29% |
| Imperial Health Plan HMO | $74 - $353 | 30% |
| Correctcare Integrated Health | $83 - $399 | 34% |
| Coalinga State Hospital | $128 - $614 | 53% |
| Naphcare Inc-Mendota | $138 - $660 | 57% |
| Medi-Cal Alameda Alliance for Health | $197 | 81% |
| Chdp | $197 | 81% |
| Ccs Fresno | $197 | 81% |
| Generic Care Out of County | $197 | 81% |
| Ccs Merced | $197 | 81% |
| Ccs Madera/Sacramento | $197 | 81% |
| Ccs Stanislaus | $197 | 81% |
| Santa Clara Family Health Plan - Valley Health | $197 | 81% |
| Ccs Kern | $197 | 81% |
| Ccs Kings | $197 | 81% |
| Genetically Handicapped Person | $197 | 81% |
| Cal Caloptima | $197 | 81% |
| Medi-Cal La Care Health | $197 | 81% |
| Ccs Tulare | $197 | 81% |
| Medi-Cal Partnership Health Plan of Ca | $197 | 81% |
| Medi-Cal Community Health Group | $197 | 81% |
| Generic Ccs Other Counties | $197 | 81% |
| Fresno County Funded Specialty Care | $197 | 81% |
| Medi-Cal California Health & Wellness Plan | $197 | 81% |
| Medi-Cal Kern Family Health | $197 | 81% |
| Medi-Cal Blue Shield Promise Health | $197 | 81% |
| Medi-Cal Contra Costa Health Plan | $197 | 81% |
| Medi-Cal Health Plan of San Mateo | $197 | 81% |
| Gold Coast Medi-Cal | $197 | 81% |
| Medi-Cal Cencal Health | $197 | 81% |
| Ccs Mariposa | $197 | 81% |
| Medi-Cal Inland Empire Health | $197 | 81% |
| San Francisco Health Plan Medi-Cal | $197 | 81% |
| Medi-Cal Molina | $197 | 81% |
| Santa Clara Family Health Plan - Premier Health | $197 | 81% |
| Kaiser | $244 | 100% |
| Sequoia Pace | $295 | 121% |
| Health Plan of San Joaquin | $295 | 121% |
| Adventist -McL Calviva Sub Cap | $325 | 133% |
| Healthnet | $379 - $3,302 | 155% |
| Network By Design | $1,345 - $4,219 | 552% |
| Central Valley Medical Providers | $1,406 - $3,938 | 577% |
| Community Care | $1,434 | 588% |
| Employer 90/40 | $2,250 | 923% |
| Nx Health Network PPO | $3,094 | 1269% |
| Central Ca Indian Health | $3,094 | 1269% |
| Healthsmart | $3,825 - $4,500 | 1569% |
| Coventry Health Care (First Health Network) | $4,219 | 1731% |
| Generic Multiplan | $4,781 | 1961% |
| PHCS | $4,781 | 1961% |