CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Kaleida Health

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $322
Cash Discount Price: $910
vs. Medicare Baseline: 1.32x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Kaleida Health is $322. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $910. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.32x the Medicare baseline. Located in 100 High Street, Buffalo, NY.

Cash / Self-Pay

$910

Average discount available for prompt cash payment at this facility.

Insurance Median

$322

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: $910 (373%)

Insurance Median: $322 (132%)

Cash: $910 (373% of Medicare)

Ins. Median: $322 (132% 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.

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
Highmark Wny	$60 - $83	25%
Univera Healthcare	$120	49%
Ghi/Emblem Health	$157 - $402	64%
Ghi/Emblem Health - Wchob	$157 - $197	64%
Aetna	$164 - $316	67%
Magnacare	$164 - $210	67%
Magnacare - Wchob	$164 - $210	67%
Independent Health Association	$173 - $554	71%
Independent Health Association - Wchob	$180 - $554	74%
Blue Cross Blue Shield	$203 - $1,111	83%
Tricare	$283	116%
Univera	$292 - $1,112	120%
Wellcare	$310	127%
Fidelis	$322	132%
UnitedHealthcare	$323	133%
Cigna	$348 - $423	143%
Univera - Wchob	$404 - $1,112	166%

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 $910.
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 Kaleida Health 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.