CMS Price Transparency Data

MRI, knee or other leg joint

Facility: North Adams Regional Hospital Corporation

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,628
  • Cash Discount Price: $3,384
  • vs. Medicare Baseline: 6.68x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at North Adams Regional Hospital Corporation is $1,628. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,384. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.68x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$3,384

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,628

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: $3,384 (1388%)
Insurance Median: $1,628 (668%)
Cash: $3,384 (1388% of Medicare)
Ins. Median: $1,628 (668% 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 668% of the Medicare baseline (a markup of 568%). 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
Medicare (plans) $209 - $827 86%
Tricare $210 - $1,340 86%
Comm Hospice $213 - $819 87%
Mcr Miscellaneous $213 - $819 87%
Mcrmanaged Usa Family $213 - $819 87%
Mcrmanaged Va $213 - $819 87%
Oth United Vaccn $213 - $819 87%
Mcd New York $222 - $274 91%
Blue Cross Blue Shield $241 - $3,028 99%
Mcrmanaged Cca One Care $241 - $811 99%
Aetna $251 - $2,689 103%
Mcd Masshealth $274 - $448 112%
Mcd Out Of State $274 - $448 112%
Mcdmanaged Cdphp $274 - $448 112%
Mcdmanaged Hne Mcdaco $274 - $448 112%
Medicaid / KanCare $274 - $1,567 112%
Comm Network Qhpsub $301 - $2,013 123%
Mcdmanaged Network $301 - $2,013 123%
Comm Fallon Qhp $315 - $2,016 129%
Mcdmanaged Bmchnp $315 - $466 129%
Comm Hne Hmo $400 - $2,347 164%
Comm Hne $425 - $2,484 174%
Comm Hne Ppo $425 - $2,494 174%
Comm Unicare $516 - $2,310 212%
Wc Workers Comp $578 - $2,161 237%
Comm Network Qhpnonsub $1,611 - $2,561 661%
Comm Nhp $1,628 - $2,305 668%
Comm Tufts $1,993 - $2,821 818%
UnitedHealthcare $2,165 - $3,063 888%
Cigna $2,265 - $3,313 929%
Comm Cdphp $2,265 - $3,206 929%
Comm Mvp $2,265 - $3,206 929%
Comm Oxford $2,265 - $3,206 929%
Comm First Health $2,341 - $3,384 960%
Comm Connecticare $2,391 - $3,384 981%
Comm Consolidated Health $2,391 - $3,384 981%
Comm Harvard $2,391 - $3,384 981%
Comm Other $2,391 - $3,384 981%
Comm Phcs $2,391 - $3,384 981%
Comm Self Pay $2,391 - $3,384 981%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals