CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Nemours Childrens Hospital, Florida

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $2,337
Cash Discount Price: $3,928
vs. Medicare Baseline: 9.59x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Nemours Childrens Hospital, Florida is $2,337. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,928. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.59x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.

Cash / Self-Pay

$3,928

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,337

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: $3,928 (1611%)

Insurance Median: $2,337 (959%)

Cash: $3,928 (1611% of Medicare)

Ins. Median: $2,337 (959% 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 959% of the Medicare baseline (a markup of 859%). 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
Tricare	$243	100%
Avmed	$900	369%
Truli	$1,381 - $1,571	567%
Aetna	$1,391	571%
Florida Blue	$1,535 - $2,912	630%
Employers Health Network Fl	$1,571	644%
Evolutions Healthcare	$1,802	739%
Integra Administrative Group	$2,357	967%
Cigna	$2,475	1015%
Global Medical Management	$2,553	1047%
Prime Health Services	$2,553	1047%
Star Healthcare Network	$2,553	1047%
UnitedHealthcare	$2,912	1195%
Velocity	$2,946	1209%
First Health Network	$3,064	1257%
Pnoa	$3,142	1289%
Seminole Tribe Of Fl	$3,142	1289%
Private Healthcare Systems	$3,614	1483%

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 $3,928.
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 Nemours Childrens Hospital, Florida 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.