CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Lancaster General Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,547
  • Cash Discount Price: $1,820
  • vs. Medicare Baseline: 6.35x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Lancaster General Hospital is $1,547. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,820. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 6.35x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$1,820

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,547

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: $1,820 (747%)
Insurance Median: $1,547 (635%)
Cash: $1,820 (747% of Medicare)
Ins. Median: $1,547 (635% 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 635% of the Medicare baseline (a markup of 535%). 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
Medicaid / KanCare $203 - $473 83%
Tricare $218 89%
Highmark $240 - $2,600 98%
Albright Life $242 99%
Coatesville Va $242 99%
Hospice Generic $242 99%
Lebanon Veterans Hospital $242 99%
Medicare (plans) $242 - $268 99%
UnitedHealthcare $242 - $2,210 99%
Aetna $245 - $1,760 101%
Blue Cross Blue Shield $246 - $2,573 101%
Amerihealth Caritas $247 101%
Cigna $250 - $1,962 103%
Health Partners Mcr Advantage $250 103%
Devoted Health $255 105%
Pa Health And Wellness Mcr $255 105%
Elap Employees $344 141%
Hospice And Community Care $346 - $494 142%
Oscar Health Plan $473 194%
Old Order Group $491 - $832 201%
Lg Coresource/Lg Eliance $519 - $741 213%
Lancashire Hall $546 - $2,600 224%
Nursing Home Op Services $546 - $780 224%
Claim Watcher Plus $727 298%
Affilia Home Health $728 - $2,600 299%
Masonic Homes $764 - $2,600 313%
Claim Watcher $800 328%
Elap Other Groups $882 362%
Eliance Health Solutions $1,165 - $1,664 478%
Highmark Commercial Preferred $1,218 - $2,600 500%
Gateway $1,225 - $1,615 503%
Ehp $1,492 - $2,132 612%
Upmc Commercial $1,492 - $2,210 612%
Devon $1,547 - $2,210 635%
Geisinger Commercial $1,547 - $2,210 635%
Intergroup Services $1,547 - $2,210 635%
Preferred Healthcare $1,547 - $2,210 635%
Medi-Share Christian Care $1,729 - $2,470 709%
Commercial Generic $1,820 - $2,600 747%
Highmark Commercial Non-Preferred $1,820 - $2,621 747%
Magellan $1,820 - $2,600 747%
United Behavioral Health $1,820 - $2,600 747%
Value Options $1,820 - $2,600 747%
Workers Compensation $1,820 - $2,600 747%
Gift Of Life Donor Program $13,500 5538%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals