CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Santa Clara Valley Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price medium confidence

A fair price for this

$20,175

about 1.4× the $14,044 Medicare rate · typically $13,085–$41,312

modeled estimate · not a bill or quote

What this hospital charges insurers

$15,669

Below the fair price — a good deal

about $4,506 under the fair price · 1.1× Medicare

Medicare pays $14,044 Fair price $20,175 This hospital $15,669 Cash price $52,986 Hospital's list price $75,694

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

One of the lower prices — 6 of 8 other CA hospitals charge more for the same procedure.

Cheapest $9,517 Priciest $18,312

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Hip or knee replacement (inpatient stay) is about $20,175 (about 1.4× the $14,044 Medicare rate). Santa Clara Valley Medical Center charges insurers about $15,669, or about $52,986 in cash — below the fair price — a good deal. Located in San Jose, CA.

What each insurance company pays

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

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

✓ Aetna UnitedHealthcareBlue Cross Blue ShieldCignaHumanaKaiser 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
Aetnamajor	$19,350	138%
+ 1 smaller / regional plan	$11,988

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 (about 52,986), 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 Santa Clara Valley 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 Santa Clara Valley Medical Center

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
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
San Dimas Community Hospital · San Dimas $18,312

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