CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: HCA Florida South Shore Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $15,069
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at HCA Florida South Shore Hospital is $15,069. 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 1.07x the Medicare baseline. Located in 4016 Sun City Center Blvd, Sun City Center, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,069

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: $15,069 (107%)
Ins. Median: $15,069 (107% 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 - $15,069 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%
Hillsborough County Sb $7,862 56%
Wellmed $13,932 99%
Simply Healthcare $14,191 - $15,212 101%
Access 2 Healthcare Physicians Freedom Optimum Group Members $14,216 101%
Ultimate Health Plan $14,216 101%
United Va Ccn $14,216 101%
Access 2 Healthcare Physicians Freedom Health $14,359 102%
Access 2 Healthcare Physicians Optimum $14,359 102%
Aetna $14,359 - $35,624 102%
Blue Cross Blue Shield $14,359 - $44,815 102%
Freedom Health Care $14,359 102%
Optimum Healthcare $14,359 102%
Devoted Health $14,501 103%
Careplus $14,927 106%
American Health Plan $15,069 107%
Clear Spring Health $15,212 108%
Align Senior Care $15,354 109%
Florida Complete Care $15,354 109%
Longevity Health Plan $15,354 109%
Secur $15,354 109%
Gold Kidney Of Florida $15,496 - $16,349 110%
Centurion $15,638 111%
Solis Health Plan $15,638 111%
Baycare Health Plans $16,065 114%
Sunshine State $16,847 120%
Wellcare $16,847 120%
Ndms Definitive Care $17,771 127%
Oscar $18,764 134%
Evolutions Healthcare Systems $22,086 157%
Truli $35,232 - $42,885 251%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4016 Sun City Center Blvd, Sun City Center, FL 33573
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals