CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: HCA Florida Aventura Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $20,710
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at HCA Florida Aventura Hospital is $20,710. 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 1.47x the Medicare baseline. Located in 20900 Biscayne Blvd, Aventura, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$20,710

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: $20,710 (147%)
Ins. Median: $20,710 (147% 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 $1,629 - $53,012 12%
Molina $1,834 - $21,662 13%
Sunshine State Health Plan $1,984 - $13,561 14%
Cigna $2,102 - $31,041 15%
Humana $2,139 - $41,013 15%
United $3,000 - $43,711 21%
Medica Healthcare $15,050 107%
Simply Healthcare $15,427 110%
Oscar $15,709 - $21,061 112%
Wellmed $19,456 139%
Leon Health $19,657 140%
Careplus Sfl $20,058 - $23,066 143%
United Behavioral Health $20,058 143%
Veterans Evaluation Services $20,058 143%
Blue Cross Blue Shield $20,258 - $44,212 144%
Devoted Health $20,459 146%
Amerihealth Caritas $20,498 - $21,061 146%
Aetna $20,559 - $54,902 146%
Health Sun Health Plan $20,860 149%
Sunshine State $21,061 - $22,063 150%
American Health Plan $21,261 151%
Mmm Of Fl (Health Advantage Plan) $21,261 151%
Prominence Healthfirst $21,261 151%
Longevity Health Plan $21,462 153%
Align $21,662 154%
Doctors Healthcare Plan $21,662 154%
Florida Complete Care $21,662 154%
Simply Healthcare Plans $21,662 154%
Aids Healthcare $21,863 156%
Centurion $22,063 157%
Freedom Health $22,866 163%
Optimum $22,866 163%
Solis Health Plan $22,866 163%
Gold Kidney $23,066 164%
Ndms Definitive Care $25,072 179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 20900 Biscayne Blvd, Aventura, FL 33180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals