CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mercy Hospital of Buffalo

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $159
  • Cash Discount Price: $816
  • vs. Medicare Baseline: 0.65x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mercy Hospital of Buffalo is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $816. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.65x the Medicare baseline. Located in 565 Abbott Road, Buffalo, NY.
Cash / Self-Pay
$816

Average discount available for prompt cash payment at this facility.

Insurance Median
$159

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: $816 (335%)
Insurance Median: $159 (65%)
Cash: $816 (335% of Medicare)
Ins. Median: $159 (65% 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.

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 $43 - $618 18%
Medicaid / KanCare $51 - $330 21%
Blue Cross Blue Shield $52 - $1,136 21%
VA Veterans Affairs [700001] $53 - $199 22%
Univera Healthcare Essential [100170] $54 - $606 22%
Univera Healthcare [100169] $54 - $246 22%
Beacon Essential [350122] $56 - $239 23%
Fidelis Essential [100163] $56 - $1,136 23%
Excellus Rochester McD [350117] $57 - $330 23%
Vna Option Mltc [350110] $57 - $330 23%
Independent Health Essential [100166] $57 - $330 23%
Tuscarora Nation [550120] $57 - $330 23%
Crime Victims [100176] $57 - $330 23%
Amerigroup [350102] $57 - $330 23%
Ghi [100153] $59 - $189 24%
Medicare (plans) $61 - $356 25%
Hospice [550001] $62 - $199 25%
Covid19 Hrsa [45013] $62 - $199 25%
Humana $62 - $209 25%
Champ VA [700002] $62 - $199 25%
Magnacare [100142] $62 - $199 25%
Fallon Health [450115] $62 - $199 25%
Cigna $62 - $289 25%
Tricare $62 - $199 25%
Catholic Health Life Pace [400005] $62 - $199 25%
Seneca Nation [450119] $62 - $199 25%
Meritain [100063] $62 - $199 25%
Aetna $62 - $209 25%
Fidelis Dual Advantage [450120] $64 - $209 26%
Wellcare Fidelis Dual [450451] $64 - $209 26%
Independent Health [100165] $68 - $589 28%
Iha First Choice [800001] $68 - $553 28%
Wellcare [450129] $68 - $219 28%
Fidelis Exchange [100164] $75 - $239 31%
Beacon Health Options [100023] $75 - $239 31%
Mvp Healthcare [100168] $84 - $277 34%
UPMC Health Plan [100181] $89 - $510 37%
Molina Essential [100167] $129 - $1,136 53%
Federal Workers Compensation [500100] $155 - $777 64%
No Fault [114001] $155 - $777 64%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 565 Abbott Road, Buffalo, NY 14220
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals