Molina Healthcare Knee Replacement Rates in Sarasota-Bradenton
Published Molina Healthcare negotiated rates for Knee Replacement at 5 hospitals in Sarasota-Bradenton, FL. Data from CMS-mandated hospital transparency files.
Lowest Rate
$171.54
Sarasota Memorial Hospital
all plan types
Highest Rate
$6,434.60
Sarasota Memorial Hospital - Venice
all plan types
Rate Spread
38x
across all plan types
Hospitals
5
with Molina Healthcare data
Molina Healthcare's negotiated knee-replacement rates in Sarasota-Bradenton span a 38x range, from $171.54 at Sarasota Memorial Hospital (Healthy Kids) to $6,434.60 at Sarasota Memorial Hospital - Venice. The median across five hospitals is $1,608.18. Lower figures often reflect Medicaid or Medicare plan types rather than commercial coverage.
Molina Healthcare Knee Replacement Rates by Hospital
| Hospital | Lowest Molina Healthcare Rate |
|---|---|
| Sarasota Memorial Hospital | $171.54 |
| HCA Florida Blake Hospital | $1,950 |
| HCA Florida Englewood Hospital | $1,950 |
| HCA Florida Sarasota Doctors Hospital | $1,950 |
| Sarasota Memorial Hospital - Venice | $6,434.60 |
Median of all 22 published Molina Healthcare rates for Knee Replacement at these hospitals: $1,608.18
Rates shown are Molina Healthcare's published negotiated rates from each hospital's CMS transparency file. "Lowest rate" is the lowest rate across all Molina Healthcare 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 Molina Healthcare Negotiated Rates
A negotiated rate is the price Molina Healthcare 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 Molina Healthcare 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 Sarasota-Bradenton
Frequently Asked Questions
Where is the lowest-cost Molina Healthcare Knee Replacement in Sarasota-Bradenton?
The lowest Molina Healthcare negotiated rate for Knee Replacement in Sarasota-Bradenton is $171.54 at Sarasota Memorial Hospital, across all plan types including Medicaid-managed and Medicare Advantage. The highest is $6,434.60 at Sarasota Memorial Hospital - Venice, a 38x difference. Commercial plan rates typically fall between these extremes.
Is the Molina Healthcare negotiated rate what I'll pay?
Not necessarily. The negotiated rate is what Molina Healthcare 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 Molina Healthcare for a pre-service cost estimate specific to your plan.
How many Sarasota-Bradenton hospitals have published Molina Healthcare rates?
5 hospitals in the Sarasota-Bradenton area have published Molina Healthcare 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 Molina Healthcare directly.
Does Molina Healthcare require prior authorization for knee replacement?
Almost all Molina Healthcare plans require prior authorization for knee replacement surgery. Without authorization, Molina Healthcare 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 Molina Healthcare 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 Molina Healthcare 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 Molina Healthcare website: www.molinahealthcare.com