CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Forbes Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $214
Cash Discount Price: $2,037
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Forbes Hospital is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,037. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.88x the Medicare baseline. Located in 2570 Haymaker Road, Monroeville, PA.

Cash / Self-Pay

$2,037

Average discount available for prompt cash payment at this facility.

Insurance Median

$214

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: $2,037 (836%)

Insurance Median: $214 (88%)

Cash: $2,037 (836% of Medicare)

Ins. Median: $214 (88% 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
Univera	$53 - $245	22%
Amerihealth	$66 - $547	27%
Highmark	$74 - $454	30%
Pennsylvania Health And Wellness	$82 - $497	34%
Geisinger	$90 - $530	37%
UnitedHealthcare	$90 - $735	37%
Cigna	$103 - $542	42%
American Health Plans	$233	96%
Life Pittsburgh	$233	96%
Martin'S Point	$233	96%
Medicare (plans)	$240	98%
Aetna	$242 - $663	99%
Highmark Wholecare	$246 - $457	101%
Humana	$246	101%
Molina	$253	104%
Medical Mutual	$679	279%
University Of Pittsburgh Medical Center	$2,959 - $3,645	1214%

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 $2,037.
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 Forbes 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.