CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Eastern Idaho Regional Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$15,839

about 1.1× the $14,044 Medicare rate · typically $14,351–$23,552

modeled estimate · not a bill or quote

What this hospital charges insurers

$37,301

Well above the fair price

about $21,462 over the fair price · 2.7× Medicare

Medicare pays $14,044 Fair price $15,839 This hospital $37,301

How we calculate the fair BaseRate →

How this hospital compares to other ID hospitals

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

Cheapest $14,117 Priciest $37,301

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

A fair price for a Hip or knee replacement (inpatient stay) is about $15,839 (about 1.1× the $14,044 Medicare rate). Eastern Idaho Regional Medical Center charges insurers about $37,301 — well above the fair price. Located in Idaho Falls, ID.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $15,839. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Humana AetnaCignaKaiser 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	$7,737 - $54,268	55%
Blue Cross Blue Shieldmajor	$16,482 - $45,063	117%
Humanamajor	$16,812	120%
Molina	$16,482	117%
PacificSource	$33,304	237%
SelectHealth	$37,301 - $39,763	266%
+ 5 smaller / regional plans	$16,482 - $46,139

Government programs also on file: Military & VA.

Excludes 2 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 Eastern Idaho 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 Eastern Idaho Regional Medical Center

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

Idaho Falls Community Hospital, LLC · Idaho Falls $14,117
Northwest Specialty Hospital · Post Falls $14,216
Mountain View Hospital · Idaho Falls $15,322
Kootenai Health · Coeur D'Alene $16,232
St Luke's Nampa Medical Center · Nampa $17,270
Madison Memorial Hospital · Rexburg $17,726
West Valley Medical Center · Caldwell $17,800
Treasure Valley Hospital · Boise $19,045

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