CMS Price Transparency Data

MRI, knee or other leg joint

Facility: St Luke's Hospital - Upper Bucks Campus

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,229
  • Cash Discount Price: $5,794
  • vs. Medicare Baseline: 5.04x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at St Luke's Hospital - Upper Bucks Campus is $1,229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,794. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.04x the Medicare baseline. Located in 3000 St. Luke's Drive, Quakertown, PA.
Cash / Self-Pay
$5,794

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,229

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: $5,794 (2377%)
Insurance Median: $1,229 (504%)
Cash: $5,794 (2377% of Medicare)
Ins. Median: $1,229 (504% 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 504% of the Medicare baseline (a markup of 404%). 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 $247 - $1,480 101%
Highmark $247 - $855 101%
Aetna $252 - $2,247 103%
Geisinger $252 - $1,810 103%
Humana $257 105%
Upmc Health Plan $260 - $1,765 107%
UnitedHealthcare $267 - $1,861 110%
Highmark Wholecare $1,094 449%
Oscar $1,671 685%
Cigna $1,762 723%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 St. Luke's Drive, Quakertown, PA 18951
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals