CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Central Florida Lake Monroe Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $5,069
  • Cash Discount Price: $16,351
  • vs. Medicare Baseline: 20.79x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Central Florida Lake Monroe Hospital is $5,069. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,351. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 20.79x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
$16,351

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,069

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: $16,351 (6708%)
Insurance Median: $5,069 (2079%)
Cash: $16,351 (6708% of Medicare)
Ins. Median: $5,069 (2079% 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 2079% of the Medicare baseline (a markup of 1979%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
United $518 - $7,358 212%
Freedom Health $1,177 483%
Optimum $1,177 483%
Aetna $1,580 - $4,905 648%
Corvel Corporation $2,366 971%
Prime Health $2,416 991%
Careworks (Rockport Community) $2,490 1021%
Simply $2,518 1033%
Molina Healthcare $3,107 - $5,232 1275%
Avmed $3,110 - $8,176 1276%
Sunshine State Health Plan $4,170 1711%
Plotkin Health $8,176 3354%
Prime Health Sheriff $8,176 3354%
Multiplan $12,263 - $13,898 5031%
Three Rivers Provider Network $12,263 5031%
Ppo Next $13,898 5701%
Novanet $14,716 6037%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals