CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Wellspan York Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,167
Cash Discount Price: $462
vs. Medicare Baseline: 4.79x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Wellspan York Hospital is $1,167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $462. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.79x the Medicare baseline. Located in 1001 South George Street, York, PA.

Cash / Self-Pay

$462

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,167

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: $462 (190%)

Insurance Median: $1,167 (479%)

Cash: $462 (190% of Medicare)

Ins. Median: $1,167 (479% 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 479% of the Medicare baseline (a markup of 379%). 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
Johns_Hopkins_Healthcare_Plan	$237 - $2,114	97%
Medicare (plans)	$237 - $256	97%
Aetna	$244 - $2,027	100%
Medicaid / KanCare	$260 - $471	107%
Highmark	$355 - $1,459	146%
Blue_Cross	$468 - $2,002	192%
Wellspan_Capital_Blue_Cross	$474 - $2,047	194%
United_Healthcare	$1,342	551%
Cigna	$1,855 - $1,986	761%
First_Health_Network	$1,929 - $2,027	791%
Phc	$2,002	821%
Geisinger	$2,114	867%
Upmc	$2,114	867%

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 $462.
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 Wellspan York 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.