CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Advocate Sherman Hospital

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$20,663
about 1.5× the $14,044 Medicare rate · typically $14,604–$27,479
modeled estimate · not a bill or quote
What this hospital charges insurers
$22,543
About the fair price
about $1,880 over the fair price · 1.6× Medicare
Medicare pays $14,044 Fair price $20,663 This hospital $22,543

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

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

Cheapest $12,226 Priciest $22,543

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

A fair price for a Hip or knee replacement (inpatient stay) is about $20,663 (about 1.5× the $14,044 Medicare rate). Advocate Sherman Hospital charges insurers about $22,543 — about the fair price. Located in Elgin, IL.

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✓ Cigna HumanaKaiser 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 $16,087 - $19,522 115%
Blue Cross Blue Shieldmajor $15,491 - $24,655 110%
Aetnamajor $24,834 177%
Cignamajor $21,434 - $40,342 153%
Ambetter (Centene) $26,872 191%
Molina $26,872 191%
Oscar Health $27,798 198%
+ 1 smaller / regional plan $35,582
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 1425 North Randall Road, Elgin, IL 60123
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals