Florida Blue Knee Replacement Rates in Ocala

Published Florida Blue negotiated rates for Knee Replacement at 3 hospitals in Ocala, FL. Data from CMS-mandated hospital transparency files.

Lowest Rate

$13,437

HCA Florida Ocala Hospital

all plan types

Highest Rate

$13,809.38

AdventHealth Ocala

all plan types

Rate Spread

across all plan types

Hospitals

with Florida Blue data

Florida Blue's negotiated rates for knee replacement in Ocala run from $13,437 at HCA Florida Ocala Hospital (PHS) to $13,809.38 at AdventHealth Ocala, a spread of just 1x across three hospitals. The listed median is $18,340. Lowest rates can reflect Medicaid or Medicare plan types rather than commercial coverage.

Why the range is so wide: Florida Blue 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.

Florida Blue Knee Replacement Rates by Hospital

Hospital	Lowest Florida Blue Rate	Plan Type	Highest Rate	Plans
HCA Florida Ocala Hospital	$13,437	PHS	$27,429	7
HCA Florida West Marion Hospital	$13,437	PHS	$27,429	7
AdventHealth Ocala	$13,809.38	Medicare Managed Care - Hmo	$13,809.38	1

Median of all 15 published Florida Blue rates for Knee Replacement at these hospitals: $18,340

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

A negotiated rate is the price Florida Blue 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 Florida Blue 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 Ocala

Simply Healthcare $2,250 - $14,211.59 3 hospitals

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

Frequently Asked Questions

Where is the lowest-cost Florida Blue Knee Replacement in Ocala?

The lowest Florida Blue negotiated rate for Knee Replacement in Ocala is $13,437 at HCA Florida Ocala Hospital, across all plan types including Medicaid-managed and Medicare Advantage. The highest is $13,809.38 at AdventHealth Ocala. Commercial plan rates typically fall between these extremes.

Is the Florida Blue negotiated rate what I'll pay?

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

How many Ocala hospitals have published Florida Blue rates?

3 hospitals in the Ocala area have published Florida Blue 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 Florida Blue directly.

Does Florida Blue require prior authorization for knee replacement?

Almost all Florida Blue plans require prior authorization for knee replacement surgery. Without authorization, Florida Blue 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 Florida Blue 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 Florida Blue 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 Florida Blue website: www.floridablue.com