CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Harlem Hospital Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $542
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.22x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Harlem Hospital Center is $542. 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 2.22x the Medicare baseline. Located in 506 Lenox Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$542

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: $542 (222%)
Ins. Median: $542 (222% 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 222% of the Medicare baseline (a markup of 122%). 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
Healthfirst $55 - $1,232 23%
Amidacare $69 - $547 28%
Emblem $69 - $739 28%
Wellcare $74 - $492 30%
Metroplus $88 - $1,232 36%
Fidelis $99 - $1,232 41%
Oscar $103 - $1,702 42%
Aetna $111 - $1,131 46%
Blue Cross Blue Shield $286 - $1,232 117%
Vaccn $286 117%
Vnsny $286 - $696 117%
Centers Plan For Healthy Living $297 122%
United $300 - $684 123%
Centerlight $410 168%
Oxford $410 - $522 168%
Carelon $533 - $547 219%
Elderplan $533 - $572 219%
Senior Whole Health $547 224%
United Behavioral Health $547 - $602 224%
Affinity $558 - $1,232 229%
Carelon (Amida Care) $558 229%
Magnacare $615 252%
Multiplan $655 269%
Local 1199 $696 286%
Villagecare Max $696 286%
Cigna $1,285 527%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 506 Lenox Avenue, New York, NY 10037
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals