CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Saint Mary's Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $848
  • Cash Discount Price: $1,844
  • vs. Medicare Baseline: 3.48x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Saint Mary's Hospital is $848. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,844. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.48x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$1,844

Average discount available for prompt cash payment at this facility.

Insurance Median
$848

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: $1,844 (756%)
Insurance Median: $848 (348%)
Cash: $1,844 (756% of Medicare)
Ins. Median: $848 (348% 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 348% of the Medicare baseline (a markup of 248%). 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.

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
Connecticut Dept of Correction $264 - $583 108%
Aetna $280 - $394 115%
Blue Cross Blue Shield $280 - $848 115%
Medicare (plans) $280 - $292 115%
UnitedHealthcare $280 - $5,029 115%
Cca Senior Care Options $286 117%
Cigna $289 - $4,023 119%
Geha $373 - $746 153%
Harvard Pilgrim Healthcare $373 - $746 153%
1199 National Benefit Fund $394 162%
Allied Benefit Systems $394 162%
Gravie Admin Services $394 162%
Hap $394 162%
Luminare Health $394 162%
Meritain $394 162%
Nippon Life Ins $394 162%
Webtpa $394 162%
Allegiance $487 - $974 200%
Health Partners $487 - $974 200%
Magnacare $487 - $974 200%
Centivo $572 235%
Claimdoc $601 247%
Diversified Administrators $601 247%
Innovative Health Plan II $601 247%
Bcn Domestic $848 348%
Blue Benefit Administrators of Massachusetts $848 348%
Blue Care Network $848 348%
Blue Distinction Transplant $848 348%
Blue Shield - Ca $848 348%
Blue Shield - Id (Regence) $848 348%
Blue Shield - Ny Highmark Northeastern $848 348%
Blue Shield - Ny Highmark Western $848 348%
Blue Shield - PA (Highmark) $848 348%
Blue Shield - Wa (Regence) $848 348%
Health Choices $848 348%
Kaiser Domestic $848 348%
Pre-Employment $848 348%
Unicare $848 348%
Wc Domestic $848 348%
Wellpoint $848 348%
Connecticare $867 - $884 356%
Carelon Behavioral Health $1,676 - $2,514 688%
Health New England $1,778 - $2,667 729%
Allied National Global Care $2,581 - $3,872 1059%
Asrm - Reliance Standard Life Insurance $2,581 - $3,872 1059%
Christian Care Ministry $2,581 - $3,872 1059%
Dean Health $2,581 - $3,872 1059%
Fallon Health $2,581 - $3,872 1059%
Family Life Insurance Company $2,581 - $3,872 1059%
Ghc Scw $2,581 - $3,872 1059%
International Benefit Administrators $2,581 - $3,872 1059%
Lifetime Benefit Solutions $2,581 - $3,872 1059%
Manhattan Life $2,581 - $3,872 1059%
Medi Share $2,581 - $3,872 1059%
Multiplan $2,581 - $3,872 1059%
Mvp $2,581 - $3,872 1059%
PHCS $2,581 - $3,872 1059%
Pai $2,581 - $3,872 1059%
Pan-American Life $2,581 - $3,872 1059%
Paramount HMO $2,581 - $3,872 1059%
Trinity Health Share $2,581 - $3,872 1059%
Prime Health Services $2,682 - $4,023 1100%
Health Smart $2,849 - $4,275 1169%
United Behavioral Health Eap $3,352 - $5,029 1375%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals