CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Portsmouth Regional Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $3,231
Cash Discount Price: $8,612
vs. Medicare Baseline: 13.25x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Portsmouth Regional Hospital is $3,231. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,612. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 13.25x the Medicare baseline. Located in 333 Borthwick Ave, Portsmouth, NH.

Cash / Self-Pay

$8,612

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,231

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: $8,612 (3533%)

Insurance Median: $3,231 (1325%)

Cash: $8,612 (3533% of Medicare)

Ins. Median: $3,231 (1325% 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 1325% of the Medicare baseline (a markup of 1225%). 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
Blue Cross Blue Shield	$274 - $4,578	112%
Amerihealth Caritas	$284 - $426	117%
Well Sense Health Plan	$564 - $845	231%
Harvard Pilgrim	$793 - $992	325%
United	$1,771 - $6,820	727%
Maine Community Health	$2,155 - $5,475	884%
Tufts Health Plan	$2,591 - $5,910	1063%
Cigna	$2,754 - $3,591	1130%
Aetna	$4,362 - $6,541	1789%
Corvel	$4,962 - $7,440	2036%
Evernorth	$5,513 - $8,266	2262%
Mutual Of Omaha	$5,513 - $8,266	2262%
Multiplan	$5,582 - $8,370	2290%
First Health	$6,271 - $9,403	2573%
Healthcare Value Mgmt	$6,271 - $9,403	2573%
Oxford Health Plans	$6,546 - $9,816	2685%

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 $8,612.
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 Portsmouth Regional 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.