CMS Price Transparency Data
Hip or knee replacement (inpatient stay)
Facility: Larkin Community Hospital
Billing Code: 470 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 470
- Insurance Median: $17,661
- Cash Discount Price: $23,152
- vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Larkin Community Hospital is $17,661. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23,152. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.26x the Medicare baseline. Located in 7031 Sw 62Nd Ave, South Miami, FL.
Cash / Self-Pay
$23,152
Average discount available for prompt cash payment at this facility.
Insurance Median
$17,661
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%)
Cash / Self-Pay: $23,152 (165%)
Insurance Median: $17,661 (126%)
Cash: $23,152 (165% of Medicare)
Ins. Median: $17,661 (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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Sunshine Behavioral | $1,460 | 10% |
| Magellan Behav Comml-All Other Plans | $1,590 | 11% |
| Medicaid / KanCare | $1,590 - $7,885 | 11% |
| United Behavioral Health Adult Mcaid | $1,600 | 11% |
| Cenpatico Behavioral Health-All Plans | $1,644 | 12% |
| United Behavioral Health Adolescent Mcaid | $1,680 | 12% |
| Medicare (plans) | $2,200 - $22,268 | 16% |
| Beacon Health Options Comm-All Other Plans | $2,400 | 17% |
| United Behavioral Health Adult-All Other Plans | $2,500 | 18% |
| Managed Care Concepts Behavioral-All Plans | $2,750 | 20% |
| United Behavioral Health Adolescent | $2,750 | 20% |
| Florida Health Solution/Hmo-All Plans | $3,200 | 23% |
| Cigna | $4,000 - $14,417 | 28% |
| Corvel Mcaid Workers Comp | $6,008 | 43% |
| Aetna | $7,508 - $23,046 | 53% |
| Community Care Phks Mcaid-All Other Plans | $7,508 | 53% |
| Humana | $7,508 - $19,205 | 53% |
| Magellan Complete Care | $7,508 | 53% |
| Odyssey Health Mcaid Ip Only | $7,508 | 53% |
| UnitedHealthcare | $7,508 - $25,927 | 53% |
| United Prop Casualty-All Plans | $8,300 | 59% |
| Jmh Health Plan Hmo/Ppo-All Other Plans | $8,570 | 61% |
| Star Network-All Plans | $13,230 | 94% |
| Blue Cross Blue Shield | $15,572 - $25,587 | 111% |
| Corvel Mcare Workers Comp-All Plans | $17,285 | 123% |
| Molina Exch Marketplace-All Other Plans | $17,285 | 123% |
| Centurion-All Plans | $18,849 | 134% |
| Bright Health-All Other Plans | $19,078 | 136% |
| Ambetter / Centene | $19,205 | 137% |
| First Med Hp Of Fl-All Plans | $19,205 | 137% |
| Florida Comm Care Mcaid | $19,205 | 137% |
| Florida Comm Care Mcare-All Other Plans | $19,205 | 137% |
| Odyssey Health Mcare Ip Only | $19,205 | 137% |
| Ops Maritime-All Plans | $19,205 | 137% |
| Preferred Care Partners Mcare-All Plans | $19,205 | 137% |
| Doctors Healthcare-All Plans | $19,677 | 140% |
| Clear Springs Hlth-All Plans | $20,165 | 144% |
| Unicare Simply Mcare Ppo-All Plans | $20,165 | 144% |
| Careplus Health-All Other Plans | $20,459 | 146% |
| Healthsun-All Plans | $20,686 | 147% |
| Wellpath-All Plans | $21,126 | 150% |
| Coventry Comml-All Plans | $23,046 | 164% |
| Global Excel-All Plans | $23,046 | 164% |
| Guardian Life-All Plans | $23,046 | 164% |
| Haa Preferred Partners-All Plans | $23,046 | 164% |
| Fci-All Plans | $24,006 | 171% |
| Allianz (Azga)-All Plans | $24,967 | 178% |
| Federal Detention Center Ip Only-All Plans | $24,967 | 178% |
| Fdc-All Plans | $26,887 | 191% |
| Odyssey Health Ip Only-All Other Plans | $31,420 | 224% |
| Avmed-All Plans | $33,074 | 236% |
| Jipa Network-All Plans | $39,459 | 281% |
| Oscar Health-All Plans | $46,599 | 332% |