CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mt Sinai Hospital Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $268
  • Cash Discount Price: $841
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mt Sinai Hospital Medical Center is $268. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $841. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.10x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$841

Average discount available for prompt cash payment at this facility.

Insurance Median
$268

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: $841 (345%)
Insurance Median: $268 (110%)
Cash: $841 (345% of Medicare)
Ins. Median: $268 (110% 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
Partners In Hlth - All Plans $97 - $864 40%
Blue Cross Blue Shield $109 - $1,374 45%
Healthlink Hmo $122 - $1,080 50%
Healthlink Ppo - All Other Plans $122 - $1,080 50%
Compsych Ip/Op Only - All Plans $146 - $1,296 60%
Hfn Platinum $158 - $1,404 65%
Multiplan Primary Ntwrk/Phcs - All Other Plans $171 - $1,512 70%
Hfn Epo $195 - $1,728 80%
Multiplan Complementary Ntwrk $195 - $1,728 80%
Hfn Ppo - All Other Plans $214 - $1,901 88%
Cigna $240 - $2,670 98%
Tricare $248 102%
Va Healthnet - All Plans $248 102%
Advocate Physician Prtnrs Mcr $256 105%
Ambetter / Centene $256 - $2,268 105%
Cenpatico Illinicare Dual $256 105%
Cenpatico Illinicare Mcr - All Other Plans $256 105%
Humana $256 - $6,784 105%
Lawndale Christian - All Plans $256 - $1,053 105%
Meridian/Harmony D-Snp - All Plans $256 105%
Nextlevel Hlth Icp Fhp Aca - All Plans $256 105%
UnitedHealthcare $256 - $1,532 105%
Harmony Behavioral Htlh - All Plans $263 108%
Zing Mcr Adv - All Plans $266 109%
Molina Mcr - All Other Plans $268 110%
Oscar - All Plans $268 - $2,268 110%
Advocate Physician Prtnrs - All Other Plans $281 115%
Aetna $375 - $4,883 154%
Family Health Network Mcaid - All Plans $375 154%
Molina Mcaid $394 162%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals