CMS Price Transparency Data

MRI, knee or other leg joint

Facility: City of Hope National Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,387
Cash Discount Price: $3,092
vs. Medicare Baseline: 9.79x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at City of Hope National Medical Center is $2,387. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,092. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.79x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$3,092

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,387

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: $3,092 (1268%)

Insurance Median: $2,387 (979%)

Cash: $3,092 (1268% of Medicare)

Ins. Median: $2,387 (979% 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 979% of the Medicare baseline (a markup of 879%). 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
Health Net	$144 - $3,599	59%
Cal Optima	$165 - $276	68%
Heritage Provider Network	$206 - $2,597	85%
Inland Empire	$206 - $2,968	85%
Prime Healthcare Keenan	$288 - $3,562	118%
Healthcare Partners	$635	260%
Aetna	$1,093	448%
UnitedHealthcare	$1,146 - $2,078	470%
Blue Cross Blue Shield	$1,237 - $3,155	507%
Blue Shield	$1,464 - $4,422	601%
Blue Shield Covca	$1,504 - $2,256	617%
Blue Shield Promise	$1,731 - $2,597	710%
Cencal	$1,979 - $2,968	812%
La Care Health	$1,979 - $2,968	812%
Kaiser	$2,226 - $3,339	913%
Gold Coast	$2,474 - $3,710	1015%
Molina	$2,474 - $4,823	1015%
Cigna	$2,657 - $3,985	1090%
Facey	$2,721 - $4,081	1116%
St. Joseph Heritage	$2,968 - $4,452	1218%
Primecare Medical Network	$3,216 - $4,823	1319%
First Health	$3,809 - $5,713	1563%
Phcs Multiplan	$4,452 - $6,678	1826%

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 $3,092.
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 City of Hope National 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.