CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Hospital Metropolitano Dr Pila

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $209
Cash Discount Price: $650
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Hospital Metropolitano Dr Pila is $209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $650. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.86x the Medicare baseline. Located in 2435 Boulevard Luis A Ferre, Ponce, PR.

Cash / Self-Pay

$650

Average discount available for prompt cash payment at this facility.

Insurance Median

$209

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: $650 (267%)

Insurance Median: $209 (86%)

Cash: $650 (267% of Medicare)

Ins. Median: $209 (86% 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
First Medical	$63 - $325	26%
Triple S	$63 - $325	26%
Mso	$74 - $110	30%
Privado	$83	34%
Va	$106	43%
Acaa	$122	50%
Hospicio	$126	52%
Mcs	$153 - $260	63%
Tricare	$153	63%
Ch	$168	69%
Salud Correccional	$168	69%
Fondo Del Seguro Estado	$174	71%
Humana	$207 - $488	85%
Plan De Salud Menonita	$211 - $288	87%
Prossam	$232	95%
Life Link	$244	100%
Wellcare	$244	100%
Cigna	$301	123%
Bl	$325	133%
Mc	$325	133%
Aarp	$650	267%
Comerciales	$650	267%
Mapfre	$650	267%

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 $650.
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 Hospital Metropolitano Dr Pila 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.