CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Hialeah Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $276
  • Cash Discount Price: $5,909
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Hialeah Hospital is $276. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,909. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.13x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$5,909

Average discount available for prompt cash payment at this facility.

Insurance Median
$276

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: $5,909 (2424%)
Insurance Median: $276 (113%)
Cash: $5,909 (2424% of Medicare)
Ins. Median: $276 (113% 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
Aetna $142 - $5,106 58%
Humana $154 - $468 63%
Medicaid / KanCare $154 - $162 63%
UnitedHealthcare $156 - $234 64%
Veterans Administration Mill Bill $164 67%
Avmed Broad Network $182 75%
Medicare (plans) $211 - $511 87%
Dimension Health Wc $216 89%
Healthsun Health Plans $216 - $246 89%
Workers Compensation $216 89%
Leon Health Inc $233 96%
Devoted Health $234 96%
Tricare $235 96%
Bristol Hospice- Miami Dade Llc $238 98%
Catholic Hospice $238 98%
Comprehensive Home Health Care Dba Opuscare Of South Florida $238 98%
Employer Direct Healthcare $238 - $261 98%
Hcr Manor Care Services Of Fl $238 98%
Hospice Other $238 98%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $238 98%
Seasons Hospice And Pallative Care Of Southern Florida Inc $238 98%
Veterans Administration Vaccn $238 98%
Vitas Healthcare Hospice Corporation Of Fl $238 98%
Vitas Hospice Unit Agreement $238 98%
Cigna $246 - $2,085 101%
Longevity Health Plan $248 102%
Imagine Health $251 103%
Self Pay/Uninsured $257 - $292 105%
Florida Pace Centers $281 115%
Bright Health Management Commercial $285 117%
Oscar Health Plan Hix $299 123%
Naphcare Inc $328 135%
Avmed Exchange $416 171%
Ambetter / Centene $440 180%
Molina Marketplace Program Exchange $453 186%
Auto Insurance $476 195%
Avmed Select Network $487 200%
Amerihealth Caritas Next Exchange $511 210%
Bc/Bs Of Fl Miami Dade Blue Select $520 213%
Bc/Bs Of Fl Health Options Hmo $671 275%
Bc/Bs Myblue Hmo Hix $676 277%
Bc/Bs Of Fl Network Blue $678 278%
Bc/Bs Of Fl Simplyblue $712 292%
Bc/Bs Of Fl Ppo $727 298%
Bc/Bs Of Fl Blue Select Exchange Non Par $746 306%
Bc/Bs Of Fl Phs $2,451 - $3,676 1005%
Dimensions International $3,073 - $4,609 1261%
First Health $3,215 - $4,822 1319%
Dimension Health Ppo $3,546 - $5,318 1455%
Commercial Non-Contracted $4,727 - $7,091 1939%
Self Pay - Mcd Pending 100 Percent $4,727 - $7,091 1939%
Single Case Agreement $4,727 - $7,091 1939%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals