CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: HCA Florida Oak Hill Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $18,183
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at HCA Florida Oak Hill Hospital is $18,183. 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 1.29x the Medicare baseline. Located in 11375 Cortez Blvd, Brooksville, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$18,183

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: $18,183 (129%)
Ins. Median: $18,183 (129% 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 - $18,989 13%
Avmed $2,215 - $58,287 16%
Sunshine State Health Plan $2,381 - $11,906 17%
Cigna $2,999 - $43,537 21%
United $4,000 - $39,611 28%
Humana $4,363 - $45,442 31%
Simply Healthcare $15,119 - $18,810 108%
Wellmed $17,556 125%
Access 2 Healthcare Physicians Freedom Optimum Group Members $17,915 128%
Sunshine State $17,915 128%
Ultimate Health Plan $17,915 128%
United Va Ccn $17,915 128%
Wellcare $17,915 128%
Access 2 Healthcare Physicians Freedom Health $18,094 129%
Access 2 Healthcare Physicians Optimum $18,094 129%
Aetna $18,094 - $35,624 129%
Blue Cross Blue Shield $18,094 - $45,034 129%
Freedom Health Care $18,094 129%
Optimum Healthcare $18,094 129%
Devoted Health $18,273 130%
Oscar $18,764 134%
Careplus $18,810 134%
American Health Plan $18,989 135%
Align Senior Care $19,348 138%
Florida Complete Care $19,348 138%
Secur $19,348 138%
Gold Kidney Of Florida $19,527 - $20,602 139%
Centurion $19,706 140%
Evolutions Healthcare Systems $22,086 157%
Ndms Definitive Care $22,393 159%
Truli $31,252 - $43,094 223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11375 Cortez Blvd, Brooksville, FL 34613
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals