CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Geisinger-Lewistown Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,003
Cash Discount Price: $3,039
vs. Medicare Baseline: 8.22x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Geisinger-Lewistown Hospital is $2,003. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,039. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 8.22x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.

Cash / Self-Pay

$3,039

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,003

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: $3,039 (1247%)

Insurance Median: $2,003 (822%)

Cash: $3,039 (1247% of Medicare)

Ins. Median: $2,003 (822% 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 822% of the Medicare baseline (a markup of 722%). 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	$234 - $2,651	96%
Geisinger Health Plan	$234 - $1,423	96%
Medicare (plans)	$234	96%
Upmc Health Plan	$234 - $11,890	96%
Advantra	$237	97%
Humana	$237	97%
Medicaid / KanCare	$331	136%
Geisinger Family Plan	$355	146%
Amerihealth	$365	150%
Health Partners	$398	163%
Upmc Chip	$414	170%
Ambetter / Centene	$563	231%
Aetna	$2,003 - $2,382	822%
Cigna	$2,120 - $2,578	870%
UnitedHealthcare	$2,171	891%
Christian Healthcare Ministries	$2,450	1005%
Christian Health Aid	$3,921	1608%
Three Rivers Provider Network Inc.	$3,921	1608%
Multiplan	$4,166	1709%
Healthsmart Payors Organization	$4,411	1809%

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 $3,039.
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 Geisinger-Lewistown 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.