CMS Price Transparency Data

MRI, knee or other leg joint

Facility: HCA Florida North Florida Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $844
Cash Discount Price: $1,446
vs. Medicare Baseline: 3.46x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at HCA Florida North Florida Hospital is $844. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,446. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.46x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.

Cash / Self-Pay

$1,446

Average discount available for prompt cash payment at this facility.

Insurance Median

$844

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: $1,446 (593%)

Insurance Median: $844 (346%)

Cash: $1,446 (593% of Medicare)

Ins. Median: $844 (346% 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 346% of the Medicare baseline (a markup of 246%). 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
United	$145 - $868	59%
Simply	$148 - $297	61%
Molina Healthcare	$183 - $617	75%
Sunshine State Health Plan	$246 - $492	101%
Aetna	$289 - $1,816	119%
Avmed	$482 - $3,623	198%
Plotkin Health	$482 - $964	198%
Prime Health Sheriff	$482 - $964	198%
Corizon Phs	$578 - $1,157	237%
Multiplan	$752 - $1,639	308%
Evernorth	$771 - $1,542	316%
Evolutions Healthcare	$819 - $1,639	336%
Ppo Next	$819 - $1,639	336%
Novanet	$868 - $1,735	356%
Beacon Health Options	$964 - $1,928	395%
Corvel Corporation	$2,495	1024%
Prime Health	$2,548	1045%
Careworks (Rockport Community)	$2,627	1078%

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 $1,446.
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 North Florida 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.