Hip or knee replacement (inpatient stay)
Facility: HCA Florida Sarasota Doctors Hospital
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $16,578
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.18x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Molina | $1,834 - $16,735 | 13% |
| Avmed | $1,845 - $58,287 | 13% |
| Sunshine State Health Plan | $2,381 - $11,906 | 17% |
| Cigna | $2,999 - $43,537 | 21% |
| United | $4,000 - $39,611 | 28% |
| Humana | $4,363 - $45,442 | 31% |
| Wellmed | $15,472 | 110% |
| Access 2 Healthcare Physicians Freedom Optimum Group Members | $15,788 | 112% |
| Behealthy America | $15,788 | 112% |
| Ultimate Health Plan | $15,788 | 112% |
| United Behavioral Health | $15,788 | 112% |
| United Va Ccn | $15,788 | 112% |
| Access 2 Healthcare Physicians Freedom Health | $15,946 | 114% |
| Access 2 Healthcare Physicians Optimum | $15,946 | 114% |
| Aetna | $15,946 - $35,624 | 114% |
| Blue Cross Blue Shield | $15,946 - $45,671 | 114% |
| Freedom Health Care | $15,946 | 114% |
| Optimum Healthcare | $15,946 | 114% |
| Clear Spring Health | $16,578 | 118% |
| Simply Healthcare | $16,578 - $17,125 | 118% |
| American Health Plan | $16,735 | 119% |
| Secur | $17,051 | 121% |
| Align Senior Care | $17,209 | 123% |
| Florida Complete Care | $17,209 | 123% |
| Gold Kidney Of Florida | $17,209 - $18,156 | 123% |
| Centurion | $17,367 | 124% |
| Sunshine State | $18,709 | 133% |
| Wellcare | $18,709 | 133% |
| Ndms Definitive Care | $19,735 | 141% |
| Oscar | $20,358 | 145% |
| Evolutions Healthcare Systems | $22,086 | 157% |
| Truli | $34,238 - $43,703 | 244% |