CMS Price Transparency Data
MRI, knee or other leg joint
Facility: Palmetto General Hospital
Billing Code: 73721 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 73721
- Insurance Median: $453
- Cash Discount Price: $15,422
- vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Palmetto General Hospital is $453. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,422. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 1.86x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$15,422
Average discount available for prompt cash payment at this facility.
Insurance Median
$453
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: $15,422 (6326%)
Insurance Median: $453 (186%)
Cash: $15,422 (6326% of Medicare)
Ins. Median: $453 (186% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Humana | $154 - $468 | 63% |
| Medicaid / KanCare | $154 - $18,507 | 63% |
| UnitedHealthcare | $156 - $234 | 64% |
| Veterans Administration Mill Bill | $164 | 67% |
| Avmed Broad Network | $196 | 80% |
| Aetna | $205 - $13,140 | 84% |
| Medicare (plans) | $211 - $18,507 | 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% |
| Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc | $238 | 98% |
| Employer Direct Healthcare | $238 - $261 | 98% |
| Hospice Other | $238 | 98% |
| Ima Evalutations Inc | $238 | 98% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $238 | 98% |
| Opuscare Of South Fl | $238 | 98% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $238 | 98% |
| Select Specialty Hospital | $238 | 98% |
| Veterans Administration Vaccn | $238 | 98% |
| Vitas Healthcare Hospice | $238 | 98% |
| Westchester General Hospital | $238 | 98% |
| Cigna | $246 - $9,253 | 101% |
| Longevity Health Plan | $250 | 103% |
| 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 | $665 | 273% |
| Bc/Bs Of Fl Network Blue | $674 | 276% |
| Bc/Bs Myblue Hmo Hix | $684 | 281% |
| Bc/Bs Of Fl Simplyblue | $720 | 295% |
| Bc/Bs Of Fl Ppo | $727 | 298% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $742 | 304% |
| Liga Contra El Cancer | $2,000 | 820% |
| Bc/Bs Of Fl Phs | $6,190 - $9,285 | 2539% |
| Magellan Behavioral Health | $7,403 - $11,104 | 3037% |
| Dimensions International | $8,020 - $12,029 | 3290% |
| First Health | $8,266 - $12,399 | 3391% |
| Dimension Health Ppo | $9,253 - $13,880 | 3796% |
| Beacon Health Strategies Commercial | $12,338 - $18,507 | 5061% |
| Commercial Non-Contracted | $12,338 - $18,507 | 5061% |
| Self Pay - Mcd Pending 100 Percent | $12,338 - $18,507 | 5061% |
| Single Case Agreement | $12,338 - $18,507 | 5061% |
| United Behavioral Health Psych | $12,338 - $18,507 | 5061% |