CMS Price Transparency Data

MRI, knee or other leg joint

Facility: UPMC Chautauqua at Wca

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $732
Cash Discount Price: $686
vs. Medicare Baseline: 3.00x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at UPMC Chautauqua at Wca is $732. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $686. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.00x the Medicare baseline. Located in 207 Foote Avenue, Jamestown, NY.

Cash / Self-Pay

$686

Average discount available for prompt cash payment at this facility.

Insurance Median

$732

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: $686 (281%)

Insurance Median: $732 (300%)

Cash: $686 (281% of Medicare)

Ins. Median: $732 (300% 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 300% of the Medicare baseline (a markup of 200%). 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
Univera	$221	91%
Beacon	$295 - $369	121%
Fidelis	$295	121%
Humana	$295 - $914	121%
United Behavioral Health	$295	121%
UnitedHealthcare	$295 - $743	121%
Upmc Health Plan	$295 - $686	121%
Wellcare	$304	125%
Aetna	$307 - $743	126%
Independent Health	$366 - $465	150%
Magnacare	$572 - $857	235%
Geisinger	$629	258%
Blue Cross Blue Shield	$741	304%
Multiplan	$857	352%
Ghi/Emblem Health	$914	375%
Statewide Independent Ppo	$1,006	413%
Affordable First Health	$1,029	422%

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 $686.
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 UPMC Chautauqua at Wca 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.