CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Indiana Regional Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $257
  • Cash Discount Price: $822
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Indiana Regional Medical Center is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $822. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.05x the Medicare baseline. Located in 835 Hospital Road, Indiana, PA.
Cash / Self-Pay
$822

Average discount available for prompt cash payment at this facility.

Insurance Median
$257

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: $822 (337%)
Insurance Median: $257 (105%)
Cash: $822 (337% of Medicare)
Ins. Median: $257 (105% 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.

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
Highmark $159 - $685 65%
Highmark Wholecare $169 - $249 69%
Humana $188 - $245 77%
Tricare $189 - $2,282 78%
Aetna $190 - $762 78%
Cigna $191 - $623 78%
Medicare (plans) $191 - $249 78%
United Mine Workers Of America $191 - $249 78%
UnitedHealthcare $191 - $913 78%
Ambetter / Centene $198 - $363 81%
Amerihealth Caritas $198 - $355 81%
Geisinger Health Plan $198 - $437 81%
Upmc Health Plan $201 - $2,173 82%
Geisinger $268 - $697 110%
Pa Health And Wellness Commercial $268 - $697 110%
Premier Comp Solutions, Llc $375 154%
Department Of Human Services And Torrance State Hospital $1,438 590%
Miscellaneous Commercial $2,282 936%
Pa Workers Compensation $2,282 936%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 835 Hospital Road, Indiana, PA 15701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals