CMS Price Transparency Data

MRI, knee or other leg joint

Facility: UPMC Muncy

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,330
Cash Discount Price: $2,514
vs. Medicare Baseline: 9.56x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at UPMC Muncy is $2,330. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,514. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.56x the Medicare baseline. Located in 215 East Water Street, Muncy, PA.

Cash / Self-Pay

$2,514

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,330

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: $2,514 (1031%)

Insurance Median: $2,330 (956%)

Cash: $2,514 (1031% of Medicare)

Ins. Median: $2,330 (956% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 956% of the Medicare baseline (a markup of 856%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$344 - $2,866	141%
Highmark Wholecare (Prev Gateway)	$628	258%
Upmc Health Plan	$628 - $1,827	258%
Amerihealth Caritas	$647 - $2,208	265%
Cigna	$660 - $2,870	271%
Pa Health & Wellness	$679 - $2,316	279%
Upmc Work Partners	$1,176	482%
Three Rivers Provider Network	$1,259 - $3,771	516%
Blue Cross Blue Shield	$1,643 - $1,935	674%
Aetna	$1,699 - $2,765	697%
Coventry/First Health	$2,099 - $2,820	861%
Wirerope Works	$2,330	956%
Geisinger	$2,807	1151%
Multiplan	$3,268 - $3,980	1341%
America'S Choice	$3,352	1375%
Intergroup	$3,352	1375%

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 $2,514.
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 UPMC Muncy 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.