CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: St Rose Hospital

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$21,737

about 1.5× the $14,044 Medicare rate · typically $19,427–$28,445

modeled estimate · not a bill or quote

What this hospital charges insurers

$21,625

About the fair price

about $112 under the fair price · 1.5× Medicare

Medicare pays $14,044 Fair price $21,737 This hospital $21,625

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

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

Cheapest $9,517 Priciest $21,625

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

A fair price for a Hip or knee replacement (inpatient stay) is about $21,737 (about 1.5× the $14,044 Medicare rate). St Rose Hospital charges insurers about $21,625 — about the fair price. Located in Hayward, CA.

What each insurance company pays

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

6 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	$19,463 - $21,625	139%
Blue Cross Blue Shieldmajor	$3,930 - $22,031	28%
Aetnamajor	$6,200 - $22,031	44%
Cignamajor	$5,000 - $5,250	36%
Humanamajor	$22,031	157%
Kaiser Permanentemajor	$2,000	14%
Health Net	$3,720 - $21,625	26%
+ 4 smaller / regional plans	$8,280 - $22,031

Government programs also on file: Medicare.

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 Rose Hospital 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 Rose Hospital

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

Patients' Hospital of Redding · Redding $9,517
College Medical Center · Long Beach $12,743
Santa Clara Valley Medical Center · San Jose $15,669
Salinas Valley Memorial Hospital · Salinas $17,291
Shriners Hospitals for Children Northern Calif · Sacramento $17,574
French Hospital Medical Center · San Luis Obispo $17,727
Fresno Surgical Hospital · Fresno $17,982
Good Samaritan Hospital, LP · Bakersfield $18,197

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