CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: HCA Florida Jfk Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $17,632
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at HCA Florida Jfk Hospital is $17,632. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.26x the Medicare baseline. Located in 5301 S Congress Ave, Atlantis, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,632

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$14,044.15

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,044.15 (100%)
Insurance Median: $17,632 (126%)
Ins. Median: $17,632 (126% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $14,044.15 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Avmed $1,715 - $53,012 12%
Molina $1,834 - $18,578 13%
Sunshine State Health Plan $1,984 - $13,561 14%
Cigna $2,102 - $31,041 15%
Humana $2,139 - $41,013 15%
United $4,000 - $43,978 28%
Medica Healthcare $15,050 107%
Simply Healthcare $15,427 110%
Oscar $15,709 - $17,890 112%
Palm Beach Pace $16,342 116%
Wellmed $16,686 119%
Careplus Sfl $17,202 122%
United Behavioral Health $17,202 122%
Veterans Evaluation Services $17,202 122%
Blue Cross Blue Shield $17,374 - $44,212 124%
Devoted Health $17,546 125%
Mmm Of Fl (Health Advantage Plan) $17,546 125%
Aetna $17,632 - $54,902 126%
Amerihealth Caritas $17,718 - $20,900 126%
Sunshine State $17,718 - $18,922 126%
Health Sun Health Plan $17,890 127%
Longevity Health Plan $17,890 127%
Prominence Healthfirst $17,890 127%
Align $18,234 130%
American Health Plan $18,234 130%
Florida Complete Care $18,234 130%
Freedom Health $18,234 130%
Optimum $18,234 130%
Simply Healthcare Plans $18,578 132%
Aids Healthcare $18,750 134%
Doctors Healthcare Plan $18,750 134%
Centurion $18,922 135%
Solis Health Plan $19,266 137%
Gold Kidney $19,782 141%
Ndms Definitive Care $21,502 153%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5301 S Congress Ave, Atlantis, FL 33462
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals