CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Marion Communtiy Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $3,710
Cash Discount Price: $11,840
vs. Medicare Baseline: 15.22x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Marion Communtiy Hospital is $3,710. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,840. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 15.22x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.

Cash / Self-Pay

$11,840

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,710

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: $11,840 (4857%)

Insurance Median: $3,710 (1522%)

Cash: $11,840 (4857% of Medicare)

Ins. Median: $3,710 (1522% 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 1522% of the Medicare baseline (a markup of 1422%). 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	$518 - $5,564	212%
Aetna	$1,392 - $3,710	571%
Avmed	$1,567 - $3,418	643%
Simply	$1,688 - $1,904	692%
Molina Healthcare	$2,083 - $3,957	854%
Corvel Corporation	$2,253	924%
Prime Health	$2,300	944%
Careworks (Rockport Community)	$2,371	973%
Marion County Schools	$2,371	973%
Sunshine State Health Plan	$2,795 - $3,153	1147%
Plotkin Health	$5,481 - $6,183	2248%
Prime Health Sheriff	$5,481 - $6,183	2248%
Multiplan	$8,551 - $9,645	3508%
Ppo Next	$9,318 - $10,510	3822%
Novanet	$9,866 - $11,129	4047%

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 $11,840.
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 Marion Communtiy 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.