CMS Price Transparency Data

MRI, knee or other leg joint

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $401
Cash Discount Price: $3,400
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at UMass Memorial Healthalliance Hospitals is $401. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,400. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.64x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$3,400

Average discount available for prompt cash payment at this facility.

Insurance Median

$401

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: $3,400 (1395%)

Insurance Median: $401 (164%)

Cash: $3,400 (1395% of Medicare)

Ins. Median: $401 (164% 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.

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
Champva [11001]	$258	106%
Cigna	$289 - $2,047	119%
Correctional Care [11003]	$289	119%
Institution [10406]	$289 - $1,802	119%
Medicaid / KanCare	$289 - $1,768	119%
Medicare (plans)	$289	119%
Tufts Dual [10111]	$289	119%
Tufts Us Family [11203]	$289	119%
Hsno/Free Care [10801]	$294	121%
Blue Cross Blue Shield	$299 - $639	123%
Aetna	$304	125%
Commonwealth Care Mcr [10115]	$304	125%
Fallon Mcr Supp [20202]	$304	125%
Harvard Pilgrim Mcr [10106]	$304	125%
Mgb Mcr [10124]	$304	125%
Tufts Mcr [10112]	$304	125%
UnitedHealthcare	$304 - $3,400	125%
Senior Whole Health [10110]	$310	127%
Tufts Connectorcare [10507]	$492	202%
Workers Compensation [20501]	$578	237%
Tufts [11201]	$617	253%
Wellpoint [11112]	$770	316%
Hne [11108]	$1,897	778%
First Health Network [11120]	$2,550	1046%
Multiplan [11109]	$2,550	1046%
Connecticare [11105]	$3,400	1395%
Fallon Carelon Hlth [28]	$3,400	1395%
Fallon Mcaid Carelon Hlth [29]	$3,400	1395%
Grants [20507]	$3,400	1395%

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 $3,400.
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 UMass Memorial Healthalliance Hospitals 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.