CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Sarasota Memorial Hospital - Venice

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,308
Cash Discount Price: $1,395
vs. Medicare Baseline: 9.47x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Sarasota Memorial Hospital - Venice is $2,308. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,395. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.47x the Medicare baseline. Located in 2600 Laurel Road East, North Venice, FL.

Cash / Self-Pay

$1,395

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,308

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: $1,395 (572%)

Insurance Median: $2,308 (947%)

Cash: $1,395 (572% of Medicare)

Ins. Median: $2,308 (947% 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 947% of the Medicare baseline (a markup of 847%). 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
Simply Healthcare	$153 - $161	63%
Sunshine State	$161	66%
Molina	$165	68%
Amerihealth Caritas	$168	69%
Community Care Plan	$168	69%
Florida Community Care	$168 - $267	69%
Blue Cross Blue Shield	$243	100%
Aetna	$250 - $3,187	103%
UnitedHealthcare	$250 - $2,992	103%
Simply Freedom Optimum	$255	105%
Wellcare	$255	105%
Ambetter / Centene	$655	269%
Avmed	$2,182 - $2,908	895%
Usa Managed Care	$2,391 - $3,187	981%
First Health	$2,481 - $3,307	1018%
Careworks	$2,514 - $2,615	1031%
Enlyte	$2,514 - $2,615	1031%

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 $1,395.
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 Sarasota Memorial Hospital - Venice 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.