CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Atrium Health Navicent Rehabilitation Hopsital

Billing Code: 470 (MS-DRG)

The BaseRate · fair price medium confidence

A fair price for this

$25,965

about 1.8× the $14,044 Medicare rate · typically $12,125–$37,525

modeled estimate · not a bill or quote

What this hospital charges insurers

$22,004

Below the fair price — a good deal

about $3,961 under the fair price · 1.6× Medicare

Medicare pays $14,044 Fair price $25,965 This hospital $22,004

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 $22,004

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 $25,965 (about 1.8× the $14,044 Medicare rate). Atrium Health Navicent Rehabilitation Hopsital charges insurers about $22,004 — below the fair price — a good deal. Located in Macon, 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	$17,214 - $43,299	123%
Blue Cross Blue Shieldmajor	$17,214 - $26,519	123%
Aetnamajor	$17,214 - $26,765	123%
Cignamajor	$22,004	157%
Humanamajor	$17,214 - $36,755	123%
Kaiser Permanentemajor	$32,868	234%
Clover Health	$17,558	125%
+ 7 smaller / regional plans	$17,049 - $38,566

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 Atrium Health Navicent Rehabilitation Hopsital 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 Atrium Health Navicent Rehabilitation Hopsital

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.