CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Northwest Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$20,312

about 1.4× the $14,044 Medicare rate · typically $16,511–$22,613

modeled estimate · not a bill or quote

What this hospital charges insurers

$19,960

About the fair price

about $352 under the fair price · 1.4× Medicare

Medicare pays $14,044 Fair price $20,312 This hospital $19,960

How we calculate the fair BaseRate →

How this hospital compares to other AZ hospitals

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

Cheapest $13,152 Priciest $19,960

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

A fair price for a Hip or knee replacement (inpatient stay) is about $20,312 (about 1.4× the $14,044 Medicare rate). Northwest Medical Center charges insurers about $19,960 — about the fair price. Located in Tucson, AZ.

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	$2,500 - $25,006	18%
Blue Cross Blue Shieldmajor	$15,250 - $51,418	109%
Aetnamajor	$14,980 - $21,401	107%
Cignamajor	$14,980 - $25,620	107%
Humanamajor	$14,900	106%
Ambetter (Centene)	$21,843	156%
Banner Health	$15,727	112%
Clover Health	$16,725	119%
Devoted Health	$15,428	110%
Health Net	$19,916	142%
WellCare	$15,727	112%
+ 10 smaller / regional plans	$14,980 - $35,075

Government programs also on file: Medicare, Military & VA.

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 Northwest Medical Center 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 Northwest Medical Center

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

Northern Cochise Community Hospital, Inc. · Willcox $13,152
Yavapai Regional Medical Center · Prescott $14,155
Havasu Regional Medical Center · Lake Havasu City $14,683
Banner Heart Hospital · Mesa $15,052
Honorhealth Scottsdale Shea Medical Center · Scottsdale $15,344
Banner Boswell Medical Center · Sun City $15,573
Honorhealth Deer Valley Medical Center · Phoenix $15,699
Honorhealth Sonoran Crossing Medical Center · Phoenix $15,838

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