CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Northside Hospital

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$23,907

about 1.7× the $14,044 Medicare rate · typically $15,239–$28,499

modeled estimate · not a bill or quote

What this hospital charges insurers

$22,448

About the fair price

about $1,459 under the fair price · 1.6× Medicare

Medicare pays $14,044 Fair price $23,907 This hospital $22,448

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

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

Cheapest $10,982 Priciest $22,448

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

A fair price for a Hip or knee replacement (inpatient stay) is about $23,907 (about 1.7× the $14,044 Medicare rate). Northside Hospital charges insurers about $22,448 — about the fair price. Located in Atlanta, GA.

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	$4,634 - $22,008	33%
Blue Cross Blue Shieldmajor	$3,245 - $22,008	23%
Aetnamajor	$3,841 - $22,448	27%
Cignamajor	$6,294 - $22,669	45%
Humanamajor	$22,228	158%
Kaiser Permanentemajor	$3,538 - $22,669	25%
Ambetter (Centene)	$23,109 - $43,642	165%
Amerigroup	$22,889	163%
CareSource	$23,109	165%
Clover Health	$23,109	165%
Health Net	$4,623	33%
WellCare	$22,669	161%
+ 13 smaller / regional plans	$11,041 - $31,185

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

Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 Northside 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 Northside Hospital

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

Coffee Regional Medical Center, Inc · Douglas $10,982
Bacon County Hospital · Alma $12,743
Northside Hospital Forsyth · Cumming $14,215
Phoebe Putney Memorial Hospital · Albany $14,820
Wellstar Paulding Medical Center · Hiram $15,030
Wellstar North Fulton Medical Center · Roswell $15,139
Fairview Park Hospital · Dublin $15,181
Doctors Hospital · Augusta $15,224

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