CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Idaho Falls Community Hospital, LLC

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$15,809

about 1.1× the $14,044 Medicare rate · typically $14,035–$23,629

modeled estimate · not a bill or quote

What this hospital charges insurers

$14,117

Below the fair price — a good deal

about $1,692 under the fair price · 1.0× Medicare

Medicare pays $14,044 Fair price $15,809 This hospital $14,117

How we calculate the fair BaseRate →

How this hospital compares to other ID hospitals

Lowest price of the 9 ID hospitals we have prices for — a strong deal.

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 $15,809 (about 1.1× the $14,044 Medicare rate). Idaho Falls Community Hospital, LLC charges insurers about $14,117 — below the fair price — a good deal. Located in Idaho Falls, ID.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$14,117 - $24,462	101%
Blue Cross Blue Shieldmajor	$14,117	101%
Aetnamajor	$14,117	101%
Humanamajor	$14,117	101%
Molina	$14,117	101%
PacificSource	$14,117 - $33,276	101%
SelectHealth	$14,117	101%
+ 2 smaller / regional plans	$14,117

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 Idaho Falls Community Hospital, LLC 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 Idaho Falls Community Hospital, LLC

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

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
Eastern Idaho Regional Medical Center · Idaho Falls $37,301

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