CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: St. Vincent's East

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$16,279

about 1.2× the $14,044 Medicare rate · typically $14,298–$18,195

modeled estimate · not a bill or quote

What this hospital charges insurers

$16,119

About the fair price

about $160 under the fair price · 1.1× Medicare

Medicare pays $14,044 Fair price $16,279 This hospital $16,119

How we calculate the fair BaseRate →

How this hospital compares to other AL hospitals

Highest price of the 9 AL hospitals we have prices for — worth calling around.

Cheapest $12,077 Priciest $16,119

Black dot = this hospital, among the 9 AL hospitals with a price for this procedure. Full list below.

A fair price for a Hip or knee replacement (inpatient stay) is about $16,279 (about 1.2× the $14,044 Medicare rate). St. Vincent's East charges insurers about $16,119 — about the fair price. Located in Birmingham, AL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$15,351 - $20,794	109%
Blue Cross Blue Shieldmajor	$12,476 - $14,737	89%
Aetnamajor	$15,812 - $16,318	113%
Cignamajor	$15,812 - $27,641	113%
Humanamajor	$15,505 - $27,599	110%
Ambetter (Centene)	$15,351 - $21,108	109%
+ 3 smaller / regional plans	$15,351 - $19,956

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 470.

Insurance Before you use insurance

Call your insurance company to confirm St. Vincent's East is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 470.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St. Vincent's East

Compare: Hip or knee replacement (inpatient stay) at other AL hospitals

North Alabama Medical Center · Florence $12,077
Riverview Regional Medical Center · Gadsden $12,932
Northeast Alabama Regional Medical Center · Anniston $12,989
Crestwood Medical Center · Huntsville $13,019
Grandview Medical Center · Birmingham $13,025
Hill Hospital of Sumter County · York $13,287
Medical Center Enterprise · Enterprise $13,356
Highlands Medical Center · Scottsboro $13,786

Insurance negotiated median for the same procedure, sorted lowest first.