CMS Price Transparency Data

MRI, knee or other leg joint

Facility: HCA Florida Twin Cities Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,616
Cash Discount Price: $5,030
vs. Medicare Baseline: 10.73x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at HCA Florida Twin Cities Hospital is $2,616. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,030. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.73x the Medicare baseline. Located in 2190 Hwy 85 N, Niceville, FL.

Cash / Self-Pay

$5,030

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,616

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: $5,030 (2063%)

Insurance Median: $2,616 (1073%)

Cash: $5,030 (2063% of Medicare)

Ins. Median: $2,616 (1073% 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 1073% of the Medicare baseline (a markup of 973%). 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
Simply	$517 - $1,033	212%
United	$518 - $3,018	212%
Molina Healthcare	$637 - $2,146	261%
Sunshine State Health Plan	$855 - $1,710	351%
Aetna	$1,006 - $5,100	413%
Avmed	$1,677 - $3,418	688%
Plotkin Health	$1,677 - $3,353	688%
Prime Health Sheriff	$1,677 - $3,353	688%
Evolutions Healthcare	$2,180 - $5,700	894%
Corvel Corporation	$2,388	980%
Prime Health	$2,438	1000%
Careworks (Rockport Community)	$2,513	1031%
Multiplan	$2,616 - $5,700	1073%
Ppo Next	$2,851 - $5,700	1170%
Novanet	$3,019 - $6,035	1238%

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 $5,030.
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 HCA Florida Twin Cities Hospital 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.