CMS Price Transparency Data

MRI, knee or other leg joint

Facility: St Francis Hospital - the Heart Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $518
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.12x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at St Francis Hospital - the Heart Center is $518. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.12x the Medicare baseline. Located in 100 Port Washington Boulevard, Roslyn, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$518

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%)
Insurance Median: $518 (212%)
Ins. Median: $518 (212% 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 212% of the Medicare baseline (a markup of 112%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $280 - $623 115%
Aetna $286 - $3,499 117%
Centerlight Healthcare $286 - $505 117%
Centers Plan For Healthy Living $286 117%
Elderplan Inc. $286 - $505 117%
Emblem Health $286 - $644 117%
Fidelis Care New York $286 - $1,136 117%
Health Plus $286 - $1,136 117%
Healthspring $286 117%
Independent Health $286 - $505 117%
Liberty Health $286 117%
Longevity Health Plan $286 117%
Medicare (plans) $286 - $300 117%
Mvp Health Plans $286 - $2,174 117%
Orthonet - Uniformed Services Family Health Plan $286 117%
Pmc $286 117%
Senior Whole Health $286 - $505 117%
Tricare $286 117%
UnitedHealthcare $286 - $1,136 117%
Universal Healthcare $286 117%
Us Family Health Plan $286 117%
Veterans Affairs $286 117%
Health First $289 - $1,136 119%
Humana $292 120%
Agewell New York $296 121%
Partners Health Plan $300 123%
Wellcare Health Plan Inc $315 129%
Zadroga $401 164%
Affinity Health Plan $505 - $1,136 207%
Medicaid / KanCare $505 207%
Surest $518 212%
Self Pay $623 256%
American Plan Administrators $644 264%
Amerihealth Administrators $644 264%
Benefit Services $644 264%
Ghi Cbp Ny City Employee Alternate $644 264%
International Benefit Administrator $644 264%
Ultra Benefits Inc. $644 264%
Brighton $827 - $3,396 339%
Oscar Health $1,735 712%
Apwu $2,174 892%
Centivo $2,174 - $2,694 892%
Cigna $2,174 - $2,962 892%
Daniel H Cook $2,174 892%
Nalc $2,174 892%
Samba $2,174 892%
Local 1199 $2,284 937%
Allied Wellfare Fund $2,962 1215%
American Group Administrators $2,962 1215%
Bakery & Confectionery Union $2,962 1215%
Comprehensive Benefits Consultant $2,962 1215%
Guardian Life Insurance Company Of America $2,962 1215%
Maloney And Assoc $2,962 1215%
Multiplan $2,962 1215%
Performax $2,962 1215%
Phcs $2,962 1215%
Pomco $2,962 1215%
Tpa Inc $2,962 1215%
Unicare $2,962 1215%
United Employees Health Plan $2,962 1215%
Coventry $3,132 - $3,513 1285%
Mail Handlers Benefit Plan $3,499 1435%
Meritain Health $3,499 1435%
Nippon Life Insurance Company Of America $3,499 1435%
Salvation Army $3,499 1435%
Galaxy $3,809 1563%
Three Rivers Provider Network $3,809 1563%
Aither Health $4,232 1736%
Alpha Care $4,232 1736%
Dentaquest $4,232 1736%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Port Washington Boulevard, Roslyn, NY 11576
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals