CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Reading Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,139
Cash Discount Price: $3,328
vs. Medicare Baseline: 8.77x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Reading Hospital is $2,139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,328. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.77x the Medicare baseline. Located in 420 S 5Th Avenue, West Reading, PA.

Cash / Self-Pay

$3,328

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,139

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: $3,328 (1365%)

Insurance Median: $2,139 (877%)

Cash: $3,328 (1365% of Medicare)

Ins. Median: $2,139 (877% 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 877% of the Medicare baseline (a markup of 777%). 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
Blue Cross Blue Shield	$226 - $2,951	93%
Upmc	$296 - $2,568	121%
Pa Health & Wellness	$336	138%
UnitedHealthcare	$336 - $2,218	138%
Amerihealth Caritas	$343	141%
Health Partners	$343	141%
Wernersville State Hospital	$350	144%
Aetna	$672 - $3,280	276%
Pma	$1,902	780%
Lehigh Valley Health Network	$2,139	877%
Cigna	$2,719	1115%
Geisinger	$3,010	1235%
Berkshire	$3,566	1463%
First Health	$3,661	1502%
Blue Ridge	$4,516	1853%

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 $3,328.
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 Reading 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.