CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Ocean Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $772
Cash Discount Price: $253
vs. Medicare Baseline: 3.17x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Ocean Medical Center is $772. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $253. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.17x the Medicare baseline. Located in 425 Jack Martin Blvd, Brick, NJ.

Cash / Self-Pay

$253

Average discount available for prompt cash payment at this facility.

Insurance Median

$772

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: $253 (104%)

Insurance Median: $772 (317%)

Cash: $253 (104% of Medicare)

Ins. Median: $772 (317% 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 317% of the Medicare baseline (a markup of 217%). 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
Karna	$113 - $402	46%
Aetna	$242 - $3,359	99%
Amerigroup	$242	99%
Horizon	$242 - $3,542	99%
Vaccn	$242 - $264	99%
Wellcare	$242 - $264	99%
United Community/Americhoice	$254 - $277	104%
Blue Cross Blue Shield	$264	108%
UnitedHealthcare	$317 - $951	130%
Cigna	$443 - $455	182%
Oxford	$560	230%
Activecare First McO	$650 - $2,773	267%
Clover	$772	317%
Seoul Medical Group	$832 - $852	341%
Amerihealth	$945 - $961	388%
Qualcare	$2,083 - $3,291	854%
Intergroup	$2,773	1138%
Brighton Health Plan	$2,960	1214%
Prime Health	$3,170	1300%
Multiplan - PHCS	$3,368 - $3,646	1382%
Bergen Risk	$4,332	1777%

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 $253.
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 Ocean 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.