Aetna Knee Replacement Rates in Houston
Published Aetna negotiated rates for Knee Replacement at 31 hospitals in Houston, TX. Data from CMS-mandated hospital transparency files.
Lowest Rate
$1,997
St Luke's Patients Medical Center
all plan types
Highest Rate
$19,990.64
Memorial Hermann The Woodlands Medical Center
all plan types
Rate Spread
10x
across all plan types
Hospitals
31
with Aetna data
Aetna knee replacement rates in Houston vary dramatically, with a 10x spread from $1,997 to $19,991 across 31 hospitals. The lowest rate appears at St Luke's Patients Medical through a commercial HMO plan, while MH Woodlands commands the highest price. The median negotiated rate stands at $3,774.
Aetna Knee Replacement Rates by Hospital
Rates shown are Aetna's published negotiated rates from each hospital's CMS transparency file. "Lowest rate" is the lowest rate across all Aetna plan types (including Medicaid-managed and Medicare Advantage) at that hospital. Commercial plan rates are typically higher. Your actual cost depends on your specific plan's deductible, copay, and coinsurance.
Understanding Aetna Negotiated Rates
A negotiated rate is the price Aetna has agreed to pay a hospital for a specific service. This is not necessarily what you pay out of pocket. If you have met your annual deductible, you typically pay a copay or coinsurance percentage of the negotiated rate. If you have not met your deductible, you may owe the full negotiated rate.
The same insurer often negotiates different rates at different hospitals, and different plan types (HMO, PPO, high-deductible) within the same insurer can have different rates at the same hospital. The table above shows the range across all Aetna plan types at each facility.
Prices shown are facility fees only. You will also receive separate bills from the physician performing the procedure.
Compare Other Insurers for Knee Replacement in Houston
Frequently Asked Questions
Where is the lowest-cost Aetna Knee Replacement in Houston?
The lowest Aetna negotiated rate for Knee Replacement in Houston is $1,997 at St Luke's Patients Medical Center, across all plan types including Medicaid-managed and Medicare Advantage. The highest is $19,990.64 at Memorial Hermann The Woodlands Medical Center, a 10x difference. Commercial plan rates typically fall between these extremes.
Is the Aetna negotiated rate what I'll pay?
Not necessarily. The negotiated rate is what Aetna has agreed to pay the hospital. Your out-of-pocket cost depends on your deductible, copay, and coinsurance. If you have not met your annual deductible, you may owe the full negotiated rate. Contact Aetna for a pre-service cost estimate specific to your plan.
How many Houston hospitals have published Aetna rates?
31 hospitals in the Houston area have published Aetna negotiated rates for Knee Replacement in their CMS transparency files. Having a published rate does not necessarily confirm current network participation. Verify your network status with Aetna directly.
Does Aetna require prior authorization for knee replacement?
Almost all Aetna plans require prior authorization for knee replacement surgery. Without authorization, Aetna can deny the claim entirely. Start the approval process well before your planned surgery date and confirm what documentation your plan requires.
We are not affiliated with Aetna or any hospital listed on this page. Negotiated rates are sourced from hospital-published CMS transparency files and represent the amounts agreed between the insurer and hospital. Your actual out-of-pocket cost depends on your deductible, copay, and coinsurance. Contact Aetna or the hospital billing department for a cost estimate specific to your plan. All insurer and hospital names are trademarks of their respective owners.
Visit the official Aetna website: www.aetna.com