CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Orthocolorado Hosp at St Anthony Med Campus

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$20,204

about 1.4× the $14,044 Medicare rate · typically $15,722–$30,240

modeled estimate · not a bill or quote

What this hospital charges insurers

$22,582

About the fair price

about $2,378 over the fair price · 1.6× Medicare

Medicare pays $14,044 Fair price $20,204 This hospital $22,582

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 $22,582

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 $20,204 (about 1.4× the $14,044 Medicare rate). Orthocolorado Hosp at St Anthony Med Campus charges insurers about $22,582 — about the fair price. Located in Lakewood, 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	$14,342 - $43,881	102%
Blue Cross Blue Shieldmajor	$14,490 - $30,140	103%
Aetnamajor	$14,490 - $45,495	103%
Cignamajor	$14,490 - $50,361	103%
Humanamajor	$14,490	103%
Kaiser Permanentemajor	$14,490 - $21,395	103%
Devoted Health	$14,490	103%
+ 3 smaller / regional plans	$14,490 - $25,435

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 Orthocolorado Hosp at St Anthony Med Campus 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 Orthocolorado Hosp at St Anthony Med Campus

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.