CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Marion Communtiy Hospital

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$19,546

about 1.4× the $14,044 Medicare rate · typically $16,432–$20,820

modeled estimate · not a bill or quote

What this hospital charges insurers

$19,629

About the fair price

about $83 over the fair price · 1.4× Medicare

Medicare pays $14,044 Fair price $19,546 This hospital $19,629

How we calculate the fair BaseRate →

How this hospital compares to other FL hospitals

Highest price of the 9 FL hospitals we have prices for — worth calling around.

Cheapest $9,376 Priciest $19,629

Black dot = this hospital, among the 9 FL hospitals with a price for this procedure. Full list below.

A fair price for a Hip or knee replacement (inpatient stay) is about $19,546 (about 1.4× the $14,044 Medicare rate). Marion Communtiy Hospital charges insurers about $19,629 — about the fair price. Located in Ocala, FL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$5,388 - $41,466	38%
Blue Cross Blue Shieldmajor	$17,315 - $41,467	123%
Aetnamajor	$17,486 - $32,806	125%
Cignamajor	$2,374 - $78,075	17%
Humanamajor	$4,954 - $47,551	35%
AvMed	$1,496 - $48,897	11%
Devoted Health	$17,486	125%
Molina	$2,201 - $18,172	16%
Simply Healthcare	$15,119	108%
WellCare	$17,400	124%
WellMed	$16,800	120%
+ 16 smaller / regional plans	$2,336 - $41,144

Government programs also on file: Military & VA.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 470.

Insurance Before you use insurance

Call your insurance company to confirm Marion Communtiy Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 470.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Marion Communtiy Hospital

Compare: Hip or knee replacement (inpatient stay) at other FL hospitals

Palm Beach Gardens Medical Center · Palm Beach Gardens $9,376
Sacred Heart Hospital on the Emerald Coast · Miramar Beach $11,614
Ascension Sacred Heart Gulf · Port Saint Joe $11,774
Sacred Heart Hospital · Pensacola $12,400
Jay Hospital · Jay $14,553
Gulf Breeze Hospital · Gulf Breeze $14,745
Villages Regional Hospital, The · The Villages $15,040
HCA Florida Pasadena Hospital A Part of HCA Florid · Saint Petersburg $15,054

Insurance negotiated median for the same procedure, sorted lowest first.