CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Boston Children's Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,228
Cash Discount Price: $3,137
vs. Medicare Baseline: 9.14x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Boston Children's Hospital is $2,228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,137. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.14x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$3,137

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,228

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: $3,137 (1287%)

Insurance Median: $2,228 (914%)

Cash: $3,137 (1287% of Medicare)

Ins. Median: $2,228 (914% 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 914% of the Medicare baseline (a markup of 814%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Unicare	$1,160	476%
Blue Cross Blue Shield	$1,378 - $2,071	565%
Cdphp	$1,537 - $2,666	631%
Harvard Pilgrim	$1,594 - $2,120	654%
United	$1,876 - $2,621	770%
Aetna	$1,882 - $2,630	772%
Mgb/Allways	$1,908 - $2,319	783%
Tufts Public Plan	$1,927 - $1,931	790%
United Ri Nj Ny	$1,976	811%
Ambetter / Centene	$1,983	813%
Carelon Strategies/Bhs	$2,039	836%
UnitedHealthcare	$2,039 - $2,666	836%
Carelon/Beacon	$2,353	965%
Fallon	$2,394 - $2,418	982%
Health New England	$2,535	1040%
Cigna	$2,666 - $2,831	1094%
Ets/Lifetrac	$2,666	1094%
Interlink Transplant	$2,666	1094%
Community Health Options	$2,823	1158%
Humana	$2,823	1158%
Coventry/Hcvm/First Health	$2,886	1184%
Multiplan/Phcs	$2,886 - $2,980	1184%

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 $3,137.
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 Boston Children's Hospital 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.