CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Metropolitan Hospital Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $531
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.18x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Metropolitan Hospital Center is $531. 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 2.18x the Medicare baseline. Located in 1901 First Avenue, New York, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$531

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: $531 (218%)

Ins. Median: $531 (218% 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 218% of the Medicare baseline (a markup of 118%). 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
Healthfirst	$56 - $1,194	23%
Amidacare	$70 - $531	29%
Emblem	$70 - $717	29%
Wellcare	$75 - $492	31%
Metroplus	$88 - $1,194	36%
Fidelis	$100 - $1,194	41%
Oscar	$104 - $1,702	43%
Aetna	$111 - $1,131	46%
Blue Cross Blue Shield	$286 - $1,194	117%
Vaccn	$286	117%
Vnsny	$286 - $696	117%
Centers Plan For Healthy Living	$297	122%
United	$300 - $664	123%
Centerlight	$410	168%
Oxford	$410 - $522	168%
Carelon	$531 - $533	218%
Senior Whole Health	$531	218%
United Behavioral Health	$531 - $584	218%
Elderplan	$533 - $572	219%
Affinity	$541 - $1,194	222%
Carelon (Amida Care)	$541	222%
Magnacare	$615	252%
Multiplan	$655	269%
Local 1199	$696	286%
Villagecare Max	$696	286%
Cigna	$1,285	527%

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 $X.
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 Metropolitan Hospital 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.