Ambetter Knee Replacement Rates in Nashville

Published Ambetter negotiated rates for Knee Replacement at 12 hospitals in Nashville, TN. Data from CMS-mandated hospital transparency files.

Lowest Rate

$171.11

Vanderbilt University Medical Center

all plan types

Highest Rate

$31,911.71

Maury Regional Medical Center

all plan types

Rate Spread

186x

across all plan types

Hospitals

with Ambetter data

Why the range is so wide: Ambetter negotiates different rates for different plan types. Medicaid-managed and Medicare Advantage plans typically have the lowest negotiated rates. Commercial PPO and HMO plans are higher. The "lowest rate" at each hospital may be a Medicaid or Medicare plan rate, not a commercial plan rate. The plan type is shown in the table where available.

Ambetter Knee Replacement Rates by Hospital

Hospital	Lowest Ambetter Rate	Plan Type	Highest Rate	Plans
Vanderbilt University Medical Center	$171.11	Exchange	$26,592	31
Metro Nashville General Hospital	$17,244.03	Exchange	$17,244.03	1
TriStar Centennial Medical Center	$18,954	Select	$20,500	2
TriStar Hendersonville Medical Center	$18,954	Select	$20,500	2
TriStar Horizon Medical Center	$18,954	Select	$20,500	2
TriStar NorthCrest Medical Center	$18,954	Select	$20,500	2
TriStar Skyline Medical Center	$18,954	Select	$20,500	2
TriStar Southern Hills Medical Center	$18,954	Select	$20,500	2
TriStar StoneCrest Medical Center	$18,954	Select	$20,500	2
TriStar Summit Medical Center	$18,954	Select	$20,500	2
Vanderbilt Wilson County Hospital	$20,913.18	Exchange	$25,989.21	2
Maury Regional Medical Center	$31,911.71	Commercial Exchange	$31,911.71	1

Median of all 51 published Ambetter rates for Knee Replacement at these hospitals: $1,156.31

Rates shown are Ambetter's published negotiated rates from each hospital's CMS transparency file. "Lowest rate" is the lowest rate across all Ambetter 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 Ambetter Negotiated Rates

A negotiated rate is the price Ambetter 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 Ambetter 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 Nashville

BlueCross BlueShield of Tennessee $452.86 - $32,971 16 hospitals UnitedHealthcare $97.47 - $31,961 16 hospitals Aetna $132.77 - $23,491 15 hospitals Cigna $266.88 - $34,140 14 hospitals Oscar Health $272.94 - $31,422.51 12 hospitals Humana $145.20 - $14,000 11 hospitals

View all Knee Replacement prices in Nashville (cash + insured) →

Frequently Asked Questions

Where is the lowest-cost Ambetter Knee Replacement in Nashville?

The lowest Ambetter negotiated rate for Knee Replacement in Nashville is $171.11 at Vanderbilt University Medical Center, across all plan types including Medicaid-managed and Medicare Advantage. The highest is $31,911.71 at Maury Regional Medical Center, an 186x difference. Commercial plan rates typically fall between these extremes.

Is the Ambetter negotiated rate what I'll pay?

Not necessarily. The negotiated rate is what Ambetter 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 Ambetter for a pre-service cost estimate specific to your plan.

How many Nashville hospitals have published Ambetter rates?

12 hospitals in the Nashville area have published Ambetter 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 Ambetter directly.

Does Ambetter require prior authorization for knee replacement?

Almost all Ambetter plans require prior authorization for knee replacement surgery. Without authorization, Ambetter 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 Ambetter 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 Ambetter 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 Ambetter website: www.ambetterhealth.com