CMS Price Transparency Data

MRI, knee or other leg joint

Facility: O'Connor Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $871
  • Cash Discount Price: $542
  • vs. Medicare Baseline: 3.57x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at O'Connor Hospital is $871. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $542. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.57x the Medicare baseline. Located in 460 Andes Road, Delhi, NY.
Cash / Self-Pay
$542

Average discount available for prompt cash payment at this facility.

Insurance Median
$871

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: $542 (222%)
Insurance Median: $871 (357%)
Cash: $542 (222% of Medicare)
Ins. Median: $871 (357% 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 357% of the Medicare baseline (a markup of 257%). 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
Blue Cross Blue Shield $103 - $2,948 42%
Emblem $113 - $1,253 46%
UnitedHealthcare $113 - $1,253 46%
Cdphp $117 - $1,290 48%
Mvp $117 - $1,290 48%
Aetna $121 - $3,132 50%
Fidelis $121 - $1,341 50%
Humana $122 - $1,353 50%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 460 Andes Road, Delhi, NY 13753
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals