Optimum HealthCare Knee Replacement Rates in Orlando
Published Optimum HealthCare negotiated rates for Knee Replacement at 4 hospitals in Orlando, FL. Data from CMS-mandated hospital transparency files.
Lowest Rate
$1,950
HCA Florida Lake Monroe Hospital
all plan types
Highest Rate
$1,950
HCA Florida Poinciana Hospital
all plan types
Rate Spread
1x
across all plan types
Hospitals
4
with Optimum HealthCare data
All four Orlando hospitals in the data list the same Optimum HealthCare negotiated rate for knee replacement: $1,950. That puts the lowest rate (HCA Florida Lake Monroe Hospital) and the highest (HCA Florida Poinciana Hospital) at the same figure, a 1x spread. Rates tied to Medicaid or Medicare plans can appear lower than commercial ones, so plan type affects what each figure represents.
Optimum HealthCare Knee Replacement Rates by Hospital
| Hospital | Lowest Optimum HealthCare Rate |
|---|---|
| HCA Florida Lake Monroe Hospital | $1,950 |
| HCA Florida Osceola Hospital | $1,950 |
| HCA Florida Oviedo Medical Center | $1,950 |
| HCA Florida Poinciana Hospital | $1,950 |
Median of all 16 published Optimum HealthCare rates for Knee Replacement at these hospitals: $1,950
Rates shown are Optimum HealthCare's published negotiated rates from each hospital's CMS transparency file. "Lowest rate" is the lowest rate across all Optimum 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 Optimum HealthCare Negotiated Rates
A negotiated rate is the price Optimum 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 Optimum 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 Orlando
Frequently Asked Questions
Where is the lowest-cost Optimum HealthCare Knee Replacement in Orlando?
The lowest Optimum HealthCare negotiated rate for Knee Replacement in Orlando is $1,950 at HCA Florida Lake Monroe Hospital, across all plan types including Medicaid-managed and Medicare Advantage. The highest is $1,950 at HCA Florida Poinciana Hospital. Commercial plan rates typically fall between these extremes.
Is the Optimum HealthCare negotiated rate what I'll pay?
Not necessarily. The negotiated rate is what Optimum 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 Optimum HealthCare for a pre-service cost estimate specific to your plan.
How many Orlando hospitals have published Optimum HealthCare rates?
4 hospitals in the Orlando area have published Optimum 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 Optimum HealthCare directly.
Does Optimum HealthCare require prior authorization for knee replacement?
Almost all Optimum HealthCare plans require prior authorization for knee replacement surgery. Without authorization, Optimum 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 Optimum 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 Optimum 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.