Total hip replacement cost in ID
What a total hip replacement costs at ID hospitals — and the fair price to aim for.
Typical commercial prices here are 59% below the fair benchmark (0.41×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Wide Procedure Spread · Upper-Quartile Skew Pricer
This hospital prices routine shoppable procedures at 1.6× Medicare (median 1.04× Fair BaseRate) while upper-quartile commercial rates jump +116% to 2.25× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.29× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 54% of shoppable procedures (44/100 Cash Honesty)
- CMS clinical safety score (69/100 safety score) with 72% patient recommendation
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.41× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Commercial insurance median sits at 1.04× Fair BaseRate (1.6× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.25×) jump +116% above the median procedure ratio (Q50 1.04×)
- Unnegotiated chargemaster list prices average 4.2× Medicare (37¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
In general, ID hospitals charge about the fair price for this. how we calculate the BaseRate →
Compared with the rest of the country, ID’s fair BaseRate ($4,850) is below the national fair price of $13,192.
Cheapest ID hospitals for a total hip replacement
- Benewah Community Hospital · Saint Maries $2,769
- Bear Lake Memorial Hospital · Montpelier $5,124
- West Valley Medical Center · Caldwell $5,146
- Eastern Idaho Regional Medical Center · Idaho Falls $5,479
- Treasure Valley Hospital · Boise $12,049
- Madison Memorial Hospital · Rexburg $12,685
- Northwest Specialty Hospital · Post Falls $13,204
Audit a Bill or Quote at ID Hospital Benchmark (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $4,773
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $4,773).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask ID Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $4,850 Fair BaseRate ($2,813 Medicare)
Your bill ($13,150) is $8,300 above the denoised Fair BaseRate ($4,850) and 4.7× the $2,813 Medicare rate.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Inpatient MS-DRG vs. Outpatient CPT Care-Setting Savings
Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.