CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Elizabethtown Community Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $310
Cash Discount Price: $2,198
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Elizabethtown Community Hospital is $310. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,198. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.27x the Medicare baseline. Located in 75 Park Street, Elizabethtown, NY.

Cash / Self-Pay

$2,198

Average discount available for prompt cash payment at this facility.

Insurance Median

$310

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: $2,198 (902%)

Insurance Median: $310 (127%)

Cash: $2,198 (902% of Medicare)

Ins. Median: $310 (127% 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 Physicians' Health Plan	$130 - $3,458	53%
UnitedHealthcare	$134 - $3,875	55%
Harvard Pilgrim	$151 - $3,366	62%
Magnacare	$151 - $3,366	62%
Coventry	$161 - $3,576	66%
Fidelis Care	$163 - $1,599	67%
Multiplan	$170 - $3,786	70%
Blue Cross Blue Shield	$172 - $3,162	71%
Humana	$182 - $230	75%
Aetna	$192 - $3,155	79%
Martins Point	$192 - $1,599	79%
Mvp	$192 - $3,286	79%
Veterans Affairs Community Care Network	$192 - $1,599	79%
Choicecare	$211 - $3,366	87%
Wellpath	$268 - $2,398	110%
Highmark Blueshield	$278 - $3,429	114%
Emblem Health	$3,366	1381%

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 $2,198.
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 Elizabethtown Community 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.