Sunshine Health Knee Replacement Rates in Miami-Fort Lauderdale-West Palm Beach
Published Sunshine Health negotiated rates for Knee Replacement at 6 hospitals in Miami-Fort Lauderdale-West Palm Beach, FL. Data from CMS-mandated hospital transparency files.
Lowest Rate
$81.80
Holy Cross Hospital
all plan types
Highest Rate
$25,473.62
Memorial Hospital West
all plan types
Rate Spread
311x
across all plan types
Hospitals
6
with Sunshine Health data
Sunshine Health's negotiated rates for knee replacement in the Miami-Fort Lauderdale-West Palm Beach area span a 311x range, from $81.80 at Holy Cross Hospital to $25,473.62 at Memorial Hospital West. The median across six hospitals is $623.87. The lowest figure is listed under a Sunshine State Health Medicaid plan, and Medicaid or Medicare rates often sit well below commercial ones.
Sunshine Health Knee Replacement Rates by Hospital
| Hospital | Lowest Sunshine Health Rate |
|---|---|
| Holy Cross Hospital | $81.80 |
| Cleveland Clinic Weston Hospital | $5,957.96 |
| Lakeside Medical Center | $13,561.23 |
| Memorial Hospital Miramar | $18,099.68 |
| Memorial Hospital Pembroke | $18,099.68 |
| Memorial Hospital West | $18,099.68 |
Median of all 24 published Sunshine Health rates for Knee Replacement at these hospitals: $623.87
Rates shown are Sunshine Health's published negotiated rates from each hospital's CMS transparency file. "Lowest rate" is the lowest rate across all Sunshine Health 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 Sunshine Health Knee Replacement Rates in Miami-Fort Lauderdale-West Palm Beach
Where Miami knee replacement rates start for Sunshine Health. The lowest published rate is $81.80 at Holy Cross Hospital, followed by $5,957.96 at Cleveland Clinic Weston Hospital and $13,561.23 at Lakeside Medical Center. At the top, Memorial Hospital Miramar, Memorial Hospital Pembroke and Memorial Hospital West each list a highest rate of $25,473.62.
How wide the Sunshine Health knee replacement spread runs. The page shows a spread of 311x, and the median of all 24 published rates is $623.87. The lowest rate at Holy Cross Hospital is tied to a plan labeled SUNSHINE STATE HEALTH MEDICAID, and Cleveland Clinic Weston Hospital's lowest is Managed Medicaid, so the low end likely reflects Medicaid plans rather than commercial plans.
What to ask about a Miami knee replacement. These are facility rates, and professional fees are billed separately. A member can ask:
- Sunshine Health, for the negotiated rate and estimated cost share under their own plan at a named hospital
- Sunshine Health, whether that hospital is in network for their plan
- The hospital, for a written estimate
Written from the rates in the table above. General information, not medical or insurance advice.
Understanding Sunshine Health Negotiated Rates
A negotiated rate is the price Sunshine Health 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 Sunshine Health 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
Frequently Asked Questions
Where is the lowest-cost Sunshine Health Knee Replacement in Miami-Fort Lauderdale-West Palm Beach?
The lowest Sunshine Health negotiated rate for Knee Replacement in Miami-Fort Lauderdale-West Palm Beach is $81.80 at Holy Cross Hospital, across all plan types including Medicaid-managed and Medicare Advantage. The highest is $25,473.62 at Memorial Hospital West, a 311x difference. Commercial plan rates typically fall between these extremes.
Is the Sunshine Health negotiated rate what I'll pay?
Not necessarily. The negotiated rate is what Sunshine Health 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 Sunshine Health for a pre-service cost estimate specific to your plan.
How many Miami-Fort Lauderdale-West Palm Beach hospitals have published Sunshine Health rates?
6 hospitals in the Miami-Fort Lauderdale-West Palm Beach area have published Sunshine Health 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 Sunshine Health directly.
Does Sunshine Health require prior authorization for knee replacement?
Almost all Sunshine Health plans require prior authorization for knee replacement surgery. Without authorization, Sunshine Health 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 Sunshine Health 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 Sunshine Health or the hospital billing department for a cost estimate specific to your plan. All insurer and hospital names are trademarks of their respective owners.