CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Children's Hospital of Philadelphia

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $3,279
Cash Discount Price: $9,801
vs. Medicare Baseline: 13.45x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Children's Hospital of Philadelphia is $3,279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,801. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 13.45x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$9,801

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,279

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: $9,801 (4021%)

Insurance Median: $3,279 (1345%)

Cash: $9,801 (4021% of Medicare)

Ins. Median: $3,279 (1345% 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 1345% of the Medicare baseline (a markup of 1245%). 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
Geisinger Medical Assistance	$363	149%
Highmark Wholecare	$404	166%
Horizon Nj Health	$1,191	489%
Medicaid / KanCare	$1,617	663%
UnitedHealthcare	$1,627 - $1,734	667%
Health Partners	$1,848	758%
Aetna	$2,580 - $2,887	1058%
Upmc Medical Assistance	$2,676	1098%
Keystone First Chip	$3,038	1246%
Keystone Health Plan East	$3,099	1271%
Blue Cross Blue Shield	$3,460 - $3,926	1419%
Geisinger Health Plan Commercial	$3,989	1636%
Jefferson Health Plans	$4,636	1902%
Cigna	$4,901	2011%
Highmark	$4,901	2011%
Qualcare	$5,391	2212%
First Health Network	$6,371	2614%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$7,841	3217%
Private Health Care Systems	$7,841	3217%
Choice Care Network	$8,821	3619%

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 $9,801.
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 Children's Hospital of Philadelphia 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.