CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: HCA Florida St Petersburg Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $19,478
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.39x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at HCA Florida St Petersburg Hospital is $19,478. 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 1.39x the Medicare baseline. Located in 6500 38Th Ave N, Saint Petersburg, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$19,478

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: $19,478 (139%)
Ins. Median: $19,478 (139% 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
Molina $1,834 - $20,144 13%
Avmed $1,845 - $58,287 13%
Sunshine State Health Plan $2,381 - $11,906 17%
Cigna $3,130 - $45,470 22%
United $4,000 - $39,611 28%
Humana $4,363 - $45,442 31%
Simply Healthcare $14,191 - $19,953 101%
Wellmed $18,623 133%
Oscar $18,764 134%
Access 2 Healthcare Physicians Freedom Optimum Group Members $19,003 135%
Sunshine State $19,003 135%
Ultimate Health Plan $19,003 135%
United Va Ccn $19,003 135%
Aetna $19,193 - $35,624 137%
Blue Cross Blue Shield $19,193 - $44,815 137%
Access 2 Healthcare Physicians Freedom Health $19,383 138%
Access 2 Healthcare Physicians Optimum $19,383 138%
Clear Spring Health $19,383 138%
Devoted Health $19,383 138%
Freedom Health Care $19,383 138%
Optimum Healthcare $19,383 138%
Align Senior Care $19,573 139%
Baycare Health Plans $19,573 139%
Florida Complete Care $19,573 139%
Careplus $19,763 141%
Suncoast Neighborly Care $19,953 142%
American Health Plan $20,144 143%
Longevity Health Plan $20,524 146%
Secur $20,524 146%
Gold Kidney Of Florida $20,714 - $21,854 147%
Centurion $20,904 149%
Solis Health Plan $20,904 149%
Wellcare $21,379 152%
Evolutions Healthcare Systems $22,086 157%
Ndms Definitive Care $23,754 169%
Truli $35,232 - $42,885 251%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6500 38Th Ave N, Saint Petersburg, FL 33710
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals