CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Ascension St Vincent's Clay County

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$19,240

about 1.4× the $14,044 Medicare rate · typically $15,016–$28,969

modeled estimate · not a bill or quote

What this hospital charges insurers

$16,139

Below the fair price — a good deal

about $3,101 under the fair price · 1.1× Medicare

Medicare pays $14,044 Fair price $19,240 This hospital $16,139

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 $16,139

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 $19,240 (about 1.4× the $14,044 Medicare rate). Ascension St Vincent's Clay County charges insurers about $16,139 — below the fair price — a good deal. Located in Middleburg, 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	$11,643 - $19,683	83%
Blue Cross Blue Shieldmajor	$7,840 - $45,663	56%
Aetnamajor	$8,850 - $54,850	63%
Cignamajor	$11,759 - $23,700	84%
Humanamajor	$11,182 - $16,012	80%
Ambetter (Centene)	$21,903	156%
AvMed	$14,888 - $20,751	106%
Bright Health	$15,563	111%
Molina	$21,327	152%
Oscar Health	$18,445	131%
WellCare	$11,528	82%
+ 10 smaller / regional plans	$10,000 - $25,938

Government programs also on file: Medicare, Medicaid, Military & VA.

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 Ascension St Vincent's Clay County 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 Ascension St Vincent's Clay County

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.