CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Wellstar North Fulton Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$23,856

about 1.7× the $14,044 Medicare rate · typically $15,181–$28,907

modeled estimate · not a bill or quote

What this hospital charges insurers

$15,139

Below the fair price — a good deal

about $8,717 under the fair price · 1.1× Medicare

Medicare pays $14,044 Fair price $23,856 This hospital $15,139

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

A typical price — 3 charge more and 5 charge less, among the 9 GA hospitals compared.

Cheapest $10,982 Priciest $15,444

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 $23,856 (about 1.7× the $14,044 Medicare rate). Wellstar North Fulton Medical Center charges insurers about $15,139 — below the fair price — a good deal. Located in Roswell, GA.

What each insurance company pays

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

5 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	$14,148 - $52,883	101%
Blue Cross Blue Shieldmajor	$14,431 - $66,157	103%
Aetnamajor	$14,148 - $52,268	101%
Cignamajor	$14,148 - $75,616	101%
Humanamajor	$14,431	103%
Ambetter (Centene)	$24,901	177%
CareSource	$15,139 - $27,731	108%
Clover Health	$15,139	108%
Oscar Health	$26,175	186%
WellCare	$14,856	106%
+ 4 smaller / regional plans	$14,856 - $26,175

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 Wellstar North Fulton 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 Wellstar North Fulton Medical Center

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
Fairview Park Hospital · Dublin $15,181
Doctors Hospital · Augusta $15,224
Memorial Health Meadows Hospital · Vidalia $15,444

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