Humana Knee Replacement Rates in Jacksonville
Published Humana negotiated rates for Knee Replacement at 12 hospitals in Jacksonville, FL. Data from CMS-mandated hospital transparency files.
Lowest Rate
$5,957.96
Baptist Medical Center Clay
all plan types
Highest Rate
$32,093
Ascension St. Vincent's St. Johns County
all plan types
Rate Spread
5x
across all plan types
Hospitals
12
with Humana data
Humana's negotiated rates for knee replacement in Jacksonville span a 5x range, from $5,957.96 at Baptist Medical Center Clay to $32,093 at Ascension St. Vincent's St. Johns County. The median across 12 hospitals is $11,000. The lowest rate is a Managed Medicaid price, and lower rates in this data often reflect Medicaid or Medicare plan types rather than commercial coverage.
Humana Knee Replacement Rates by Hospital
| Hospital | Lowest Humana Rate |
|---|---|
| Baptist Medical Center Clay | $5,957.96 |
| Baptist Medical Center Nassau | $5,957.96 |
| Baptist Medical Center South | $5,957.96 |
| Baptist Medical Center Jacksonville | $6,553.76 |
| Wolfson Children's Hospital | $6,553.76 |
| UF Health Jacksonville | $6,553.77 |
| HCA Florida Memorial Hospital | $11,000 |
| HCA Florida Orange Park Hospital | $11,000 |
| Ascension St. Vincent's Clay County | $32,092.50 |
| Ascension St. Vincent's Riverside | $32,093 |
| Ascension St. Vincent's Southside | $32,093 |
| Ascension St. Vincent's St. Johns County | $32,093 |
Median of all 47 published Humana rates for Knee Replacement at these hospitals: $11,000
Rates shown are Humana's published negotiated rates from each hospital's CMS transparency file. "Lowest rate" is the lowest rate across all Humana 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 Humana Knee Replacement Rates in Jacksonville
Where Humana knee replacement rates start in Jacksonville. The lowest published rates are $5,957.96 at Baptist Medical Center Clay, Baptist Medical Center Nassau and Baptist Medical Center South. The highest are $32,093 at Ascension St. Vincent's Riverside, Ascension St. Vincent's Southside and Ascension St. Vincent's St. Johns County.
How far the Jacksonville spread runs for Humana. The rates shown span 5x, and the median of all 47 published Humana rates for this procedure at these hospitals is $11,000. The plan types beside the lowest rates are labeled Managed Medicaid or Medicaid HMO, so the low end likely reflects those plans rather than commercial plans. The highest rates are tied to plans labeled Humana HMO.
What a Humana member can ask about a Jacksonville knee replacement. These are facility rates, and professional fees are billed separately. A member can ask:
- Humana, for their own plan's negotiated rate and estimated cost share at a named hospital
- Humana, whether that hospital is in network for their plan
- The hospital, for an estimate
Written from the rates in the table above. General information, not medical or insurance advice.
Understanding Humana Negotiated Rates
A negotiated rate is the price Humana 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 Humana 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 Jacksonville
Frequently Asked Questions
Where is the lowest-cost Humana Knee Replacement in Jacksonville?
The lowest Humana negotiated rate for Knee Replacement in Jacksonville is $5,957.96 at Baptist Medical Center Clay, across all plan types including Medicaid-managed and Medicare Advantage. The highest is $32,093 at Ascension St. Vincent's St. Johns County, a 5x difference. Commercial plan rates typically fall between these extremes.
Is the Humana negotiated rate what I'll pay?
Not necessarily. The negotiated rate is what Humana 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 Humana for a pre-service cost estimate specific to your plan.
How many Jacksonville hospitals have published Humana rates?
12 hospitals in the Jacksonville area have published Humana 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 Humana directly.
Does Humana require prior authorization for knee replacement?
Almost all Humana plans require prior authorization for knee replacement surgery. Without authorization, Humana 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 Humana 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 Humana 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 Humana website: www.humana.com