CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Atlantic Rehabilitation Institute, LLC

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,302
Cash Discount Price: $2,302
vs. Medicare Baseline: 9.44x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Atlantic Rehabilitation Institute, LLC is $2,302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,302. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.44x the Medicare baseline. Located in 200 Madison Ave, Madison, NJ.

Cash / Self-Pay

$2,302

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,302

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: $2,302 (944%)

Insurance Median: $2,302 (944%)

Cash: $2,302 (944% of Medicare)

Ins. Median: $2,302 (944% 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 944% of the Medicare baseline (a markup of 844%). 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
Aetna	$2,302	944%
All Savers Cpd	$2,302	944%
Ama Insurance Msg	$2,302	944%
Ambetter / Centene	$2,302	944%
Amerigroup Mgg (Wellpoint As Of 5/1/24)	$2,302	944%
Amerihealth Cpd	$2,302	944%
Amerihealth Mgg	$2,302	944%
Blue Cross Blue Shield	$2,302	944%
Braven Health Cpd	$2,302	944%
Braven Health Mgd	$2,302	944%
Cigna	$2,302	944%
Claim Doc Llc Cpd	$2,302	944%
First Managed Care Wc Cpd	$2,302	944%
Gateway Mgg	$2,302	944%
Medicaid / KanCare	$2,302	944%
Oscar Health Cpd	$2,302	944%
Oxford Health Plan Cpd	$2,302	944%
Oxford Mgg	$2,302	944%
Qualcare Cpd	$2,302	944%
Qualcare Lynx Wc Cpd	$2,302	944%
UnitedHealthcare	$2,302	944%
Upmc For Life Mgg	$2,302	944%
Wellcare Mgg	$2,302	944%

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 $2,302.
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 Atlantic Rehabilitation Institute, LLC 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.