CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Holyoke Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $289
Cash Discount Price: $1,485
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Holyoke Medical Center is $289. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,485. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.19x the Medicare baseline. Located in 575 Beech Street, Holyoke, MA.

Cash / Self-Pay

$1,485

Average discount available for prompt cash payment at this facility.

Insurance Median

$289

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: $1,485 (609%)

Insurance Median: $289 (119%)

Cash: $1,485 (609% of Medicare)

Ins. Median: $289 (119% 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
Aetna	$224 - $263	92%
Bmchp	$248	102%
Fallon	$248 - $289	102%
Health New England	$248 - $853	102%
Blue Cross Blue Shield	$263 - $447	108%
Tufts Health Plan	$263 - $508	108%
UnitedHealthcare	$263 - $2,598	108%
Commonwealth Care Alliance	$276	113%
Wellsense Sco	$279	114%
Wellcare	$282	116%
Senior Whole Health	$303	124%
Wellsense Direct Metals Silver	$310	127%
Cigna	$315	129%
Tufts Health Public Plans	$316 - $732	130%
Harvard Pilgrim	$350	144%
Gic Unicare	$593	243%

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 $1,485.
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 Holyoke 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.