CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Helen Hayes Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $312
Cash Discount Price: $1,664
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Helen Hayes Hospital is $312. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,664. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.28x the Medicare baseline. Located in 51 North Route 9W, West Haverstraw, NY.

Cash / Self-Pay

$1,664

Average discount available for prompt cash payment at this facility.

Insurance Median

$312

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: $1,664 (683%)

Insurance Median: $312 (128%)

Cash: $1,664 (683% of Medicare)

Ins. Median: $312 (128% 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
Capital District (Cdphp)	$199	82%
Aetna	$264	108%
Better Health Fidelis	$264 - $327	108%
Emblem Health	$298	122%
Affinity	$327	134%
Bc Empire	$327	134%
UnitedHealthcare	$348 - $500	143%
Mvp	$418	171%
Cigna	$521	214%
Oxford	$1,248	512%

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 $1,664.
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 Helen Hayes 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.