CMS Price Transparency Data

MRI, knee or other leg joint

Facility: HCA Florida South Shore Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,762
Cash Discount Price: $17,373
vs. Medicare Baseline: 11.33x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at HCA Florida South Shore Hospital is $2,762. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,373. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 11.33x the Medicare baseline. Located in 4016 Sun City Center Blvd, Sun City Center, FL.

Cash / Self-Pay

$17,373

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,762

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: $17,373 (7127%)

Insurance Median: $2,762 (1133%)

Cash: $17,373 (7127% of Medicare)

Ins. Median: $2,762 (1133% 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 1133% of the Medicare baseline (a markup of 1033%). 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 - $7,818	212%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$817	335%
Avmed	$1,080 - $3,418	443%
Aetna	$1,186 - $5,212	487%
Access 2 Healthcare Physicians Freedom Health	$1,251	513%
Access 2 Healthcare Physicians Optimum	$1,251	513%
Freedom Health Care	$1,355	556%
Optimum Healthcare	$1,355	556%
Corvel Corporation	$2,398	984%
Rockport Healthcare Group	$2,398	984%
Prime Health	$2,448	1004%
Simply Healthcare	$2,676	1098%
Molina	$3,301 - $4,691	1354%
Sunshine State Health Plan	$4,430	1817%
Plotkin Health	$8,687	3564%
Prime Health Sheriff	$8,687	3564%
Evolutions Healthcare Systems	$9,555 - $15,984	3920%
Multiplan	$13,030 - $14,767	5345%

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 $17,373.
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 South Shore 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.