CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Mercy Regional Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$17,644

about 1.3× the $14,044 Medicare rate · typically $13,423–$21,686

modeled estimate · not a bill or quote

What this hospital charges insurers

$19,381

About the fair price

about $1,737 over the fair price · 1.4× Medicare

Medicare pays $14,044 Fair price $17,644 This hospital $19,381

How we calculate the fair BaseRate →

How this hospital compares to other CO hospitals

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

Cheapest $12,404 Priciest $19,381

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

A fair price for a Hip or knee replacement (inpatient stay) is about $17,644 (about 1.3× the $14,044 Medicare rate). Mercy Regional Medical Center charges insurers about $19,381 — about the fair price. Located in Durango, CO.

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	$19,381	138%
Blue Cross Blue Shieldmajor	$19,381 - $130,528	138%
Aetnamajor	$19,381	138%
Cignamajor	$19,381	138%
Humanamajor	$19,381	138%
Kaiser Permanentemajor	$19,381	138%
+ 4 smaller / regional plans	$15,050 - $19,381

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 Mercy Regional 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 Mercy Regional Medical Center

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

San Luis Valley Regional Medical Center · Alamosa $12,404
Animas Surgical Hospital, LLC · Durango $14,539
Montrose Regional Health · Montrose $14,973
Community Hospital · Grand Junction $15,998
HCA Healthone Rose · Denver $16,378
Banner Fort Collins Medical Center · Fort Collins $16,667
Hca-Healthone DBA Swedish Medical Center · Englewood $17,033
HCA Healthone Presbyterian St Luke's · Denver $17,365

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