HealthSun Health Plans Knee Replacement Rates in Miami-Fort Lauderdale-West Palm Beach

Published HealthSun Health Plans negotiated rates for Knee Replacement at 14 hospitals in Miami-Fort Lauderdale-West Palm Beach, FL. Data from CMS-mandated hospital transparency files.

Lowest Rate

$104.81

Holy Cross Hospital

all plan types

Highest Rate

$15,284.17

Memorial Hospital West

all plan types

Rate Spread

146x

across all plan types

Hospitals

with HealthSun Health Plans data

HealthSun's negotiated knee-replacement rates across 14 Miami-Fort Lauderdale-West Palm Beach hospitals span a 146x range, from $104.81 at Holy Cross Hospital to $15,284.17 at Memorial Hospital West. The median rate is $2,050. The lowest figure is listed under a Medicare Advantage plan, and rates tied to Medicare or Medicaid products often differ from commercial rates.

Why the range is so wide: HealthSun Health Plans 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.

HealthSun Health Plans Knee Replacement Rates by Hospital

Hospital	Lowest HealthSun Health Plans Rate	Plan Type	Highest Rate	Plans
Holy Cross Hospital	$104.81	HEALTHSUN MEDICARE ADVANTAGE	$13,795.97	10
HCA Florida Aventura Hospital	$2,050	MGMCR	$2,050	4
HCA Florida JFK Hospital	$2,050	MGMCR	$2,050	4
HCA Florida JFK North Hospital	$2,050	MGMCR	$2,050	4
HCA Florida Kendall Hospital	$2,050	MGMCR	$2,050	4
HCA Florida Mercy Hospital	$2,050	MGMCR	$2,050	4
HCA Florida Northwest Hospital	$2,050	MGMCR	$2,050	4
HCA Florida Palms West Hospital	$2,050	MGMCR	$2,050	4
HCA Florida University Hospital	$2,050	MGMCR	$2,050	4
HCA Florida Westside Hospital	$2,050	MGMCR	$2,050	4
HCA Florida Woodmont Hospital	$2,050	MGMCR	$2,050	4
Memorial Hospital Miramar	$15,284.17	Medicare	$15,284.17	1
Memorial Hospital Pembroke	$15,284.17	Medicare	$15,284.17	1
Memorial Hospital West	$15,284.17	Medicare	$15,284.17	1

Median of all 53 published HealthSun Health Plans rates for Knee Replacement at these hospitals: $2,050

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

A negotiated rate is the price HealthSun Health Plans 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 HealthSun Health Plans 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 Miami-Fort Lauderdale-West Palm Beach

UnitedHealthcare $79.42 - $45,224 17 hospitals Aetna $79.42 - $31,455 16 hospitals Humana $79.42 - $14,479.74 16 hospitals Florida Blue $79.42 - $27,625 14 hospitals Cigna $79.42 - $78,199.82 14 hospitals Devoted Health $106.95 - $16,758.96 13 hospitals

View all Knee Replacement prices in Miami-Fort Lauderdale-West Palm Beach (cash + insured) →

Frequently Asked Questions

Where is the lowest-cost HealthSun Health Plans Knee Replacement in Miami-Fort Lauderdale-West Palm Beach?

The lowest HealthSun Health Plans negotiated rate for Knee Replacement in Miami-Fort Lauderdale-West Palm Beach is $104.81 at Holy Cross Hospital, across all plan types including Medicaid-managed and Medicare Advantage. The highest is $15,284.17 at Memorial Hospital West, a 146x difference. Commercial plan rates typically fall between these extremes.

Is the HealthSun Health Plans negotiated rate what I'll pay?

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

How many Miami-Fort Lauderdale-West Palm Beach hospitals have published HealthSun Health Plans rates?

14 hospitals in the Miami-Fort Lauderdale-West Palm Beach area have published HealthSun Health Plans 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 HealthSun Health Plans directly.

Does HealthSun Health Plans require prior authorization for knee replacement?

Almost all HealthSun Health Plans plans require prior authorization for knee replacement surgery. Without authorization, HealthSun Health Plans 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 HealthSun Health Plans 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 HealthSun Health Plans or the hospital billing department for a cost estimate specific to your plan. All insurer and hospital names are trademarks of their respective owners.