CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Kenmore Mercy Hospital

Billing Code: 73721 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$188

about 0.8× the $244 Medicare rate · typically $139–$298

modeled estimate · not a bill or quote

What this hospital charges insurers

$170

About the fair price

about $18 under the fair price · 0.7× Medicare

Medicare pays $244 Fair price $188 This hospital $170 Cash price $816 Hospital's list price $1,056

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $69 Priciest $170

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a MRI, knee or other leg joint is about $188 (about 0.8× the $244 Medicare rate). Kenmore Mercy Hospital charges insurers about $170, or about $816 in cash — about the fair price. Located in Kenmore, NY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$43 - $618	18%
Blue Cross Blue Shieldmajor	$52 - $1,136	21%
Aetnamajor	$65 - $209	27%
Cignamajor	$62 - $289	25%
Humanamajor	$65 - $209	27%
Amerigroup	$98 - $327	40%
Fidelis Care	$65 - $1,136	27%
Independent Health	$57 - $589	23%
Molina	$129 - $1,136	53%
MVP Health Care	$84 - $277	34%
UPMC Health Plan	$112 - $358	46%
WellCare	$65 - $219	27%
+ 16 smaller / regional plans	$54 - $777

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 816), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 73721.

Insurance Before you use insurance

Call your insurance company to confirm Kenmore Mercy Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 73721.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Kenmore Mercy Hospital

Compare: MRI, knee or other leg joint at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.