CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Gulf Breeze Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,714
Cash Discount Price: $995
vs. Medicare Baseline: 7.03x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Gulf Breeze Hospital is $1,714. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $995. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.03x the Medicare baseline. Located in 1110 Gulf Breeze Pkwy, Gulf Breeze, FL.

Cash / Self-Pay

$995

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,714

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: $995 (408%)

Insurance Median: $1,714 (703%)

Cash: $995 (408% of Medicare)

Ins. Median: $1,714 (703% 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 703% of the Medicare baseline (a markup of 603%). 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
Aetna	$154 - $5,808	63%
Cha Health Plan	$154	63%
UnitedHealthcare	$154 - $2,235	63%
Humana	$162 - $247	66%
Sunshine Health	$162	66%
Wellcare	$162 - $255	66%
Fl Community Care Ltc	$165	68%
Simply Healthcare Healthy Kids	$177	73%
Medicare (plans)	$211	87%
Hospice Covenant	$243	100%
Fl Blue	$405 - $2,156	166%
Uwf Athletes	$650 - $5,171	267%
Pensacola	$796 - $1,193	327%
Bc Fl	$1,309	537%
Hospice Regency	$1,591 - $2,387	653%
Wc Corvel	$2,126 - $7,558	872%
Cigna	$2,519 - $7,956	1033%
Hospice Emerald Coast	$2,652 - $3,978	1088%
Private Healthcare	$3,448 - $5,171	1414%
First Health	$3,686 - $5,529	1512%
Choicecare	$3,978 - $5,967	1632%
Multiplan	$4,721 - $7,081	1937%

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 $995.
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 Gulf Breeze 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.