CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Saratoga Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $69
Cash Discount Price: $1,810
vs. Medicare Baseline: 0.28x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Saratoga Hospital is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,810. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.28x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.

Cash / Self-Pay

$1,810

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

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: $1,810 (743%)

Insurance Median: $69 (28%)

Cash: $1,810 (743% of Medicare)

Ins. Median: $69 (28% 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
Cdphp	$41 - $1,193	17%
Blue Cross Blue Shield	$45 - $2,533	18%
Fidelis	$45 - $1,193	18%
Medicare (plans)	$45 - $60	18%
Tricare	$51 - $60	21%
Hamaspik	$57 - $1,246	23%
Medicaid / KanCare	$57	23%
Emblem Health Ghi	$60 - $66	25%
UnitedHealthcare	$60 - $3,257	25%
Mvp	$61 - $115	25%
Aetna	$62 - $1,773	25%
Blue Shield Highmark	$69 - $86	28%
Cigna	$95 - $115	39%
Blue Shield	$239 - $796	98%
Emblem	$286 - $300	117%
Nascentia Health Options	$292	120%
Mvp Essential Plan	$530 - $1,061	217%
Mvp Govt Programs	$530	217%
Mvp Commercial	$1,379 - $2,533	566%
Empire Plan Nyship	$2,533	1039%
Multiplan	$2,714 - $3,076	1113%
Magnacare	$3,257 - $3,438	1336%

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 $1,810.
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 Saratoga Hospital 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.