CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: HCA Florida West Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $17,881
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at HCA Florida West Hospital is $17,881. 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 1.27x the Medicare baseline. Located in 8383 N Davis Hwy, Pensacola, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,881

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: $17,881 (127%)
Ins. Median: $17,881 (127% 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 Healthcare $2,201 - $17,632 16%
Sunshine State Health Plan $2,348 - $11,736 17%
Cigna $2,374 - $78,075 17%
Avmed $2,968 - $48,897 21%
Humana $4,954 - $47,551 35%
United $6,746 - $52,703 48%
Wellmed $16,301 116%
Triwest Healthcare Alliance $16,467 117%
United Behavioral Health $16,634 118%
Blue Cross Blue Shield $16,800 - $50,234 120%
Ultimate Health Plan $16,966 121%
Aetna $17,050 - $28,413 121%
Simply $17,465 124%
American Health Plan $17,632 126%
Healthspring Of Florida $17,798 127%
Freedom Health $17,964 128%
Centurion $18,297 130%
Sunshine State $18,380 131%
Wellcare $18,380 131%
Longevity Health Plan $18,630 133%
Oscar $18,641 133%
Simply Healthcare $18,820 134%
Align Senior Care $19,129 136%
Florida Complete Care $19,129 136%
Gold Kidney Of Florida $19,129 136%
Pensacola Christian $20,415 145%
Ndms Definitive Care $20,792 148%
Naphcare $32,436 231%
Seven Corners $32,436 - $39,921 231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8383 N Davis Hwy, Pensacola, FL 32514
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals