CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Ira Davenport Memorial Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $3,350
Cash Discount Price: $4,558
vs. Medicare Baseline: 13.74x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Ira Davenport Memorial Hospital is $3,350. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,558. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 13.74x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$4,558

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,350

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: $4,558 (1870%)

Insurance Median: $3,350 (1374%)

Cash: $4,558 (1870% of Medicare)

Ins. Median: $3,350 (1374% 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 1374% of the Medicare baseline (a markup of 1274%). 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
Empire	$49 - $186	20%
Blue Cross Blue Shield	$256 - $27,659	105%
Fidelis	$256	105%
Humana	$286 - $8,205	117%
Tricare	$286	117%
Amerihealth Caritas Mcr Adv - All Plans	$289	119%
UnitedHealthcare	$2,315 - $4,786	950%
Fidelis Care - Exchange - All Plans	$2,507 - $5,014	1028%
Geisinger - All Plans	$2,652 - $5,305	1088%
Cigna	$2,840 - $5,680	1165%
Mvp Health Plan - All Plans	$2,840 - $5,680	1165%
Independent Health - All Plans	$2,963 - $5,926	1215%
Upmc - All Plans	$3,145 - $6,291	1290%
Pomco Inc - All Plans	$3,282 - $6,564	1346%
Aetna	$3,418 - $6,838	1402%
Emblem Health - All Plans	$4,011 - $8,023	1645%
Emblem/Ghi	$4,211	1727%
Martins Point - All Plans	$4,558 - $9,117	1870%
Healthnow - All Plans	$15,013 - $30,029	6159%

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 $4,558.
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 Ira Davenport Memorial 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.