CMS Price Transparency Data

MRI, knee or other leg joint

Facility: AHMC Seton Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $461
  • Cash Discount Price: $3,337
  • vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at AHMC Seton Medical Center is $461. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,337. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.89x the Medicare baseline. Located in 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
$3,337

Average discount available for prompt cash payment at this facility.

Insurance Median
$461

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: $3,337 (1369%)
Insurance Median: $461 (189%)
Cash: $3,337 (1369% of Medicare)
Ins. Median: $461 (189% 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.

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
Blue Cross Blue Shield $62 - $3,168 25%
Hill Physicians Medical Group Inc $184 - $560 75%
Medi-Cal $197 81%
San Mateo County/San Mateo County General Hospital $242 99%
Veterans Administration (Va) $243 100%
North East Medical Services $276 - $341 113%
San Francisco Health Plan $276 113%
Jade Health Care Mg $277 - $341 114%
Aetna $341 - $965 140%
Asian American Medical Group $341 - $672 140%
Blue Shield Of California $341 - $6,063 140%
Brand New Day $341 - $433 140%
Brown And Toland Medical Group $341 - $700 140%
Care Advantage $341 140%
Chinese Community Health Plan $341 - $2,086 140%
For Your Benefit $341 140%
Healthnet Seniority $341 140%
Humana $341 140%
Imperial Health Plan $341 140%
Medicare (plans) $341 140%
Pacificare $341 140%
Tricare $345 142%
Apcmg $346 - $520 142%
Canopy Health $346 - $624 142%
Covid-19 Uninsured Program $346 142%
Kaiser $346 - $3,420 142%
UnitedHealthcare $346 - $376 142%
Easy Choice Hospital Services $353 145%
Central Health Plan $368 151%
Ahmc Health $433 178%
Knox-Keene Act $433 178%
Athens Administrators $461 189%
Corvel Healthcare $461 189%
Multiplan/Bce Emergis $461 - $3,128 189%
Work Comp Other $461 189%
Health Plan Of San Mateo Healthworx $503 206%
Cmac $560 230%
Health Plan Of San Mateo $572 235%
Self Pay $626 - $1,418 257%
Workers Compensation Federal $1,093 448%
Interplan Corporation $2,503 1027%
Cigna $2,920 1198%
Private Healthcare Sytems Inc $3,128 1283%
The First Health Network $3,128 1283%
Health Net $3,199 1312%
Beech Street Corporation $3,337 1369%
Healthcare Foundation Of San Mateo $3,337 1369%
Choicecare Network $3,545 1454%
Multiplan $3,545 1454%
Mills Peninsula Health Services $3,754 1540%
Indemnity $4,171 1711%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals