BCBS Tennessee Knee Replacement Rates in Nashville

Published BlueCross BlueShield of Tennessee negotiated rates for Knee Replacement at 16 hospitals in Nashville, TN. Data from CMS-mandated hospital transparency files.

Lowest Rate

$452.86

Vanderbilt University Medical Center

all plan types

Highest Rate

$32,971

TriStar NorthCrest Medical Center

all plan types

Rate Spread

73x

across all plan types

Hospitals

with BlueCross BlueShield of Tennessee data

Knee-replacement rates negotiated by BlueCross BlueShield of Tennessee in Nashville span a 73x gap, from $452.86 at Vanderbilt University Medical Center to $32,971 at TriStar NorthCrest Medical Center. The median across 16 hospitals is $2,380.09. The lowest figure comes from Network S - Blue Select Other Commercial Plan, and rates tied to certain plan types may not reflect typical commercial pricing.

Why the range is so wide: BlueCross BlueShield of Tennessee 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.

BlueCross BlueShield of Tennessee Knee Replacement Rates by Hospital

Hospital	Lowest BlueCross BlueShield of Tennessee Rate	Plan Type	Highest Rate	Plans
Vanderbilt University Medical Center	$452.86	Network S - Blue Select Other Commercial Plan	$5,518	97
Maury Regional Medical Center	$2,051	Medicaid	$24,858	6
Vanderbilt Wilson County Hospital	$2,155	BlueCare Medicaid Managed Care Plan	$5,518	4
TriStar Centennial Medical Center	$2,179	BlueCare	$37,269	28
TriStar Hendersonville Medical Center	$2,179	BlueCare	$37,269	28
TriStar Horizon Medical Center	$2,179	BlueCare	$37,269	28
TriStar Skyline Medical Center	$2,179	BlueCare	$37,269	28
TriStar Southern Hills Medical Center	$2,179	BlueCare	$37,269	28
TriStar StoneCrest Medical Center	$2,179	BlueCare	$37,269	28
TriStar Summit Medical Center	$2,179	BlueCare	$37,269	28
HighPoint Health Sumner (Sumner Regional Medical Center)	$2,813	Blue Cross Select	$3,055	2
Metro Nashville General Hospital	$7,488	Network S Other Commercial Plan	$8,139	2
Ascension Saint Thomas Rutherford	$24,480	2422_BLUE CROSS BLUE SHIELD MISSIONPOINT REGIONAL 20221001	$28,151	8
Ascension Saint Thomas West	$24,480	2422_BLUE CROSS BLUE SHIELD MISSIONPOINT REGIONAL 20221001	$28,151	8
Ascension Saint Thomas Midtown	$24,487.25	1012_BLUE CROSS BLUE SHIELD MISSIONPOINT 20221001	$24,487.25	1
TriStar NorthCrest Medical Center	$32,971	NetworkP	$32,971	4

Median of all 328 published BlueCross BlueShield of Tennessee rates for Knee Replacement at these hospitals: $2,380.09

Rates shown are BlueCross BlueShield of Tennessee's published negotiated rates from each hospital's CMS transparency file. "Lowest rate" is the lowest rate across all BlueCross BlueShield of Tennessee 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.

Reading BlueCross BlueShield of Tennessee Knee Replacement Rates in Nashville

Where Nashville knee replacement rates start and top out. Among the 16 hospitals with BlueCross BlueShield of Tennessee rates, the lowest published figure is $452.86 at Vanderbilt University Medical Center, followed by $2,051 at Maury Regional Medical Center. At the other end, TriStar NorthCrest Medical Center shows $32,971, with Ascension Saint Thomas Rutherford at $24,480.

How wide the knee replacement spread runs in Nashville. The page shows a 73x spread between the lowest and highest rates, and the median of all 328 published rates is $2,380.09. Several of the lowest rates sit beside plan types such as Medicaid and BlueCare, so the low end likely reflects those plans rather than commercial plans. Plan names also vary by hospital, so check which plan a figure belongs to.

What BlueCross BlueShield of Tennessee members can ask before a Nashville knee replacement. These are facility rates, and professional fees are billed separately. Members can ask:

BlueCross BlueShield of Tennessee for your own plan's negotiated rate and estimated cost share at a named hospital
BlueCross BlueShield of Tennessee whether that hospital is in network for your plan
The hospital for an estimate

Written from the rates in the table above. General information, not medical or insurance advice.

Understanding BlueCross BlueShield of Tennessee Negotiated Rates

A negotiated rate is the price BlueCross BlueShield of Tennessee 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 BlueCross BlueShield of Tennessee 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

UnitedHealthcare $97.47 - $31,961 16 hospitals Aetna $132.77 - $23,491 15 hospitals Cigna $266.88 - $34,140 14 hospitals Ambetter $171.11 - $31,911.71 12 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 BlueCross BlueShield of Tennessee Knee Replacement in Nashville?

The lowest BlueCross BlueShield of Tennessee negotiated rate for Knee Replacement in Nashville is $452.86 at Vanderbilt University Medical Center, across all plan types including Medicaid-managed and Medicare Advantage. The highest is $32,971 at TriStar NorthCrest Medical Center, a 73x difference. Commercial plan rates typically fall between these extremes.

Is the BlueCross BlueShield of Tennessee negotiated rate what I'll pay?

Not necessarily. The negotiated rate is what BlueCross BlueShield of Tennessee 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 BlueCross BlueShield of Tennessee for a pre-service cost estimate specific to your plan.

How many Nashville hospitals have published BlueCross BlueShield of Tennessee rates?

16 hospitals in the Nashville area have published BlueCross BlueShield of Tennessee 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 BlueCross BlueShield of Tennessee directly.

Does BlueCross BlueShield of Tennessee require prior authorization for knee replacement?

Almost all BlueCross BlueShield of Tennessee plans require prior authorization for knee replacement surgery. Without authorization, BlueCross BlueShield of Tennessee 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 BlueCross BlueShield of Tennessee 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 BlueCross BlueShield of Tennessee 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 BlueCross BlueShield of Tennessee website: www.bcbst.com