CMS Price Transparency Data

MRI, knee or other leg joint

Facility: UPMC Horizon

Billing Code: 73721 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$296

about 1.2× the $244 Medicare rate · typically $245–$383

modeled estimate · not a bill or quote

What this hospital charges insurers

$249

Below the fair price — a good deal

about $47 under the fair price · 1.0× Medicare

Medicare pays $244 Fair price $296 This hospital $249 Cash price $4,861 Hospital's list price $8,102

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $189 Priciest $249

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a MRI, knee or other leg joint is about $296 (about 1.2× the $244 Medicare rate). UPMC Horizon charges insurers about $249, or about $4,861 in cash — below the fair price — a good deal. Located in Greenville, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$242 - $3,241	99%
Blue Cross Blue Shieldmajor	$249 - $3,695	102%
Aetnamajor	$237 - $4,861	97%
Cignamajor	$249 - $3,241	102%
Humanamajor	$6,887	2825%
AmeriHealth	$249	102%
Geisinger	$4,456	1828%
UPMC Health Plan	$206 - $1,680	85%
+ 5 smaller / regional plans	$249 - $6,644

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 4,861), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 73721.

Insurance Before you use insurance

Call your insurance company to confirm UPMC Horizon is in-network.
Ask your insurer whether prior approval is required for CPT code 73721.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at UPMC Horizon

Compare: MRI, knee or other leg joint at other PA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.