How Much Does an MRI Knee Cost in Pennsylvania?
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$307Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, an MRI knee costs up to about $307 in total at a hospital outpatient department, counting both the physician and the facility (national rates). Outside a hospital, at an independent imaging center, lab or office, Medicare's full rate in Pennsylvania averages $202, from $191 in Rest of Pennsylvania to $212 in Metropolitan Philadelphia.
- ✓Your ZIP's wage-adjusted hospital and surgery center rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Pennsylvania Medicare physician rate (2026)
-1.3% vs nationalAverage of 2 localities. Office range $191.35–$212.24.
What the whole procedure costs
The office rate above is what an imaging center, lab or office is paid for the whole test. In a hospital, the facility bills its own fee and the physician bills only the reading. These are 2026 national Medicare amounts.
Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. For a test like this the physician in a hospital bills only the reading (the professional component); outside a hospital one global fee covers the whole test, shown in the office rate above. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Your ZIP in Pennsylvania
Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
What MRI knee costs at hospitals near you
Everything above is a national average. The hospital you pick in Pennsylvania moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 15001.
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What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Pennsylvania the office and hospital physician lines for this CPT differ by $138.78.
National vs Pennsylvania
Where Pennsylvania ranks for this CPT
CPT 73721 by Pennsylvania locality
| Locality | Office |
|---|---|
| metropolitan philadelphia | $212.24 |
| rest of pennsylvania | $191.35 |
PE GPCI ranges from 0.918 to 1.041 in Pennsylvania. That index is why the same CPT is not one price statewide.
MRI Knee and how Pennsylvania is priced
Pennsylvania's fee schedule separates metro Philadelphia from the rest of the state, giving the southeast its own higher-cost locality while Pittsburgh, Harrisburg, Allentown, Erie, and rural Pennsylvania share rest-of-state adjustments. That means the state's second-largest medical market, Pittsburgh, is priced with rural counties rather than with Philadelphia. The Philadelphia locality's premium reflects the metro's wage and rent levels, which lead the state by a wide margin. For patients, the key locality question in Pennsylvania is simply whether care happens in the Philadelphia area.
Philadelphia is one of America's historic centers of academic medicine, dense with teaching hospitals, while Pittsburgh is dominated by a pair of large integrated systems whose rivalry has defined that market for years. The rural middle of the state, sometimes called the T, has far fewer options, and hospital closures there have drawn statewide attention. Residents near the edges use New York, Baltimore, or Ohio providers when convenient.
This procedure: A knee MRI without contrast (the lower extremity joint MRI code) shows the menisci, ligaments including the ACL, cartilage, and bone marrow, none of which appear on X-ray. It is the definitive test for suspected meniscus tears and ligament injuries. You lie on your back with the knee in a small coil for 20 to 40 minutes of painless but noisy scanning, and results typically reach your doctor within a couple of days.
What Is MRI Knee?
A knee MRI without contrast (the lower extremity joint MRI code) shows the menisci, ligaments including the ACL, cartilage, and bone marrow, none of which appear on X-ray. It is the definitive test for suspected meniscus tears and ligament injuries. You lie on your back with the knee in a small coil for 20 to 40 minutes of painless but noisy scanning, and results typically reach your doctor within a couple of days.
What Affects the Cost
- –The hospital versus freestanding center price gap for knee MRI is large and well documented; this is a scan worth shopping.
- –Insurer authorization rules often require an X-ray and a trial of conservative care first, adding upstream visits.
- –A confirmed meniscus or ligament tear frequently leads to arthroscopy, so the MRI often begins a bigger spending episode.
- –In patients over about 50, MRI often shows incidental degenerative findings that can prompt further, sometimes unnecessary, care.
- –The radiologist's interpretation fee is a distinct component of the price.
Questions to Ask Before Booking
- 1.Has my insurer approved this scan, and does my chart show the X-ray and conservative care they require?
- 2.What is the all-in price at the freestanding centers near me?
- 3.Given my age, could therapy first make this MRI unnecessary?
- 4.Is the authorization tied to a specific facility?
- 5.If the MRI shows a tear, what are the typical next steps and their costs?
Other featured procedures in Pennsylvania
MRI Knee in other states
MRI Knee in Pennsylvania: questions
Under 2026 Medicare rates, an MRI knee costs up to about $307 in total at a hospital outpatient department, counting both the physician and the facility (national rates). Outside a hospital, at an independent imaging center, lab or office, Medicare's full rate in Pennsylvania averages $202, from $191 in Rest of Pennsylvania to $212 in Metropolitan Philadelphia. Enter a ZIP for the exact Pennsylvania locality.
Yes. CMS splits Pennsylvania into 2 payment localities. For this CPT the office physician fee spans $20.89 from the lowest to highest locality. Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $40 for the office physician line or $13 for the hospital physician line in Pennsylvania. Medigap may cover that 20%. This is not the hospital facility fee.
It depends on where the test is done. At an independent imaging center, lab or office, $201.80 is Medicare's full rate in Pennsylvania, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $63.02) and the hospital is paid separately, which brings the national total to up to about $307. Pennsylvania ranks #27 of 51 states on the non-hospital rate (within 2% of the national office rate of $204.41).