CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: HCA Florida Lawnwood Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $17,512
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at HCA Florida Lawnwood Hospital is $17,512. 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 1.25x the Medicare baseline. Located in 1700 S 23Rd St, Fort Pierce, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17,512

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: $17,512 (125%)
Ins. Median: $17,512 (125% 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
Physician Health Partners $1,680 - $1,975 12%
Avmed $1,715 - $57,216 12%
Molina $1,834 - $18,562 13%
Sunshine State Health Plan $2,331 - $11,652 17%
Blue Cross Blue Shield $2,841 - $55,570 20%
Cigna $3,406 - $40,198 24%
United $3,458 - $49,680 25%
Kaiser $3,940 - $32,536 28%
Humana $4,630 - $57,406 33%
Rocky Mountain Health Plan $5,093 - $33,586 36%
Aetna $5,738 - $62,401 41%
Bright Health $16,966 121%
Rocky Mountain Health $16,966 121%
Total Longterm Care $16,966 121%
Triwest Health Alliance $16,966 121%
Wellmed $16,986 121%
Devoted Health $17,306 - $17,862 123%
Innovage Pace $17,306 123%
Delaware Life Insurance $17,475 124%
Mutual Of Omaha $17,475 124%
Wellcare $17,475 124%
United Behavioral Health $17,512 125%
Veterans Evaluation Services $17,512 125%
Sunshine State $17,687 - $19,263 126%
Florida Complete Care $17,862 127%
Longevity Health Plan $17,862 127%
Ultimate Health Plan $17,862 127%
Freedom Health $18,212 130%
Health Sun Health Plan $18,212 130%
Optimum $18,212 130%
Careplus $18,387 - $20,138 131%
American Health Plan $18,562 132%
Simply Healthcare Plans $18,912 135%
Centurion $19,263 137%
Solis Health Plan $19,963 142%
Ndms Definitive Care $21,889 156%
Pinnacol Workers Comp $23,743 169%
Multiplan $24,742 176%
Oscar $25,313 180%
Simply Healthcare $27,304 194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 S 23Rd St, Fort Pierce, FL 34950
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals