CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Hospital of Univ of Pennsylvania

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $4,385
  • Cash Discount Price: $9,710
  • vs. Medicare Baseline: 17.99x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Hospital of Univ of Pennsylvania is $4,385. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,710. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 17.99x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$9,710

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,385

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: $9,710 (3983%)
Insurance Median: $4,385 (1799%)
Cash: $9,710 (3983% of Medicare)
Ins. Median: $4,385 (1799% 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 1799% of the Medicare baseline (a markup of 1699%). 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
Gspp And Wissahickon Hospice $125 51%
Health Partners $203 - $9,744 83%
UnitedHealthcare $221 - $9,744 91%
Blue Cross Blue Shield $251 - $6,572 103%
Kaiser Permanente $251 - $9,744 103%
Medicare (plans) $251 - $256 103%
Philadelphia Va Medical Center $251 103%
Tricare $251 103%
Upmc $251 - $9,744 103%
Ibc $256 105%
Cigna $258 - $4,385 106%
Geisinger Health Plan $258 - $795 106%
Humana $258 - $7,795 106%
Devoted Health $263 108%
Pa Health And Wellness $263 - $414 108%
Penn Life (Living Independently For Elders) $263 108%
Aetna $266 - $9,744 109%
Medicaid / KanCare $269 - $9,744 110%
Clover Health Plan $271 111%
Keystone First $278 114%
Us Family Health Plan $288 118%
Paired Kidney Exchange $290 - $292 119%
Gateway Health Plan $311 128%
Keystone Mercy Health Plan $344 - $9,744 141%
Elap $356 146%
Claims Watcher $401 - $451 164%
Oscar Health Plan $426 175%
Centivo $451 185%
Elap Services $466 191%
Keystone Hmo Proactive $522 214%
Highmark $527 216%
Ibc Commercial Hpn $539 221%
Penn Global Medicine $665 273%
Horizon Nj Health $1,635 - $1,713 671%
Preferred Health Care Eliance $2,128 - $2,144 873%
Pgm - Regie De L'Assurance Maladie Quebec $2,225 - $2,241 913%
Pgm - Kuwait Defense $3,386 - $4,385 1389%
Qualcare $3,676 - $3,703 1508%
Olympus $3,802 - $3,829 1560%
Coventry $3,870 - $4,969 1588%
Pgm - Chop $3,870 - $3,898 1588%
Wissahickon Hospice $3,870 - $3,898 1588%
Healthamerica/Coventry $4,354 - $4,775 1786%
First Health Global $4,838 - $4,872 1985%
Health Net $5,805 - $5,846 2381%
Pgm - Royal Embassy Of Saudi Arabia $5,805 - $5,846 2381%
Pgm - Embassy Of Qatar $6,289 - $6,334 2580%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $6,289 - $6,334 2580%
Interlink $6,482 - $6,528 2659%
Pgm - Embassy Of The United Emirates/Ipc $6,772 - $6,821 2778%
Health America/Ccn $7,740 - $7,795 3175%
Intergroup $7,740 - $7,795 3175%
Pgm - Kuwait Health Division $7,740 - $7,795 3175%
Pgm - Kuwait Oil $7,740 - $7,795 3175%
Preferred Care $7,740 - $7,795 3175%
Blue Quality Centers For Transplant (Bqct) $9,675 - $9,744 3969%
City Of Philadelphia Behavioral Health $9,675 - $9,744 3969%
Commercial Other $9,675 - $9,744 3969%
International Pfs $9,675 - $9,744 3969%
Pa Medical Assistance $9,675 - $9,744 3969%
United Behavioral Health $9,675 - $9,744 3969%
Workers Compensation $9,675 - $9,744 3969%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals