CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Punxsutawney Area Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $245
Cash Discount Price: $358
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Punxsutawney Area Hospital is $245. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $358. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.01x the Medicare baseline. Located in 81 Hillcrest Drive, Punxsutawney, PA.

Cash / Self-Pay

$358

Average discount available for prompt cash payment at this facility.

Insurance Median

$245

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: $358 (147%)

Insurance Median: $245 (101%)

Cash: $358 (147% of Medicare)

Ins. Median: $245 (101% 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.

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
Highmark Wholecare	$37 - $296	15%
UnitedHealthcare	$42 - $796	17%
Tricare	$54 - $226	22%
Aetna	$60 - $692	25%
Amerihealth Caritas	$60 - $296	25%
Highmark	$60 - $3,589	25%
United Mine Workers Of America	$61 - $249	25%
Upmc Health Plan	$61 - $1,482	25%
Cigna	$62 - $988	25%
Geisinger Health Plan	$62 - $355	25%
Ambetter / Centene	$65 - $363	27%
Pa Health And Wellness Commercial	$77 - $498	32%
Geisinger	$86 - $697	35%
Humana	$245	101%
Pa Workers Compensation	$288 - $1,663	118%

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 $358.
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 Punxsutawney Area 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.