CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Lehigh Valley Hospital - Macungie

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $443
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Lehigh Valley Hospital - Macungie is $443. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.82x the Medicare baseline. Located in 3369 State Route 100, Macungie, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$443

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%)

Insurance Median: $443 (182%)

Ins. Median: $443 (182% 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
Blue Cross Blue Shield	$246 - $1,806	101%
Highmark Blue Shield	$249 - $662	102%
Humana	$249	102%
Amerihealth	$253	104%
Cigna	$253 - $680	104%
Geisinger	$253 - $1,082	104%
Aetna	$258 - $1,229	106%
Jefferson Health Partners	$258 - $492	106%
Upmc	$261 - $1,199	107%
Gateway	$263	108%
Emblem	$266 - $1,098	109%
Pa Health & Wellness (Allwell)	$271	111%
Highmark Wholecare/Gateway	$342 - $421	140%
Pa Health & Wellness	$363 - $447	149%
Amerihealth Caritas	$390 - $481	160%
Ambetter / Centene	$746	306%
Valley Preferred	$1,435	589%

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 $X.
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 Lehigh Valley Hospital - Macungie 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.