CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: St Mary Medical Center Inc

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$26,073

about 1.9× the $14,044 Medicare rate · typically $15,137–$31,089

modeled estimate · not a bill or quote

What this hospital charges insurers

$28,897

About the fair price

about $2,824 over the fair price · 2.1× Medicare

Medicare pays $14,044 Fair price $26,073 This hospital $28,897 Cash price $33,527 Hospital's list price $55,879

How we calculate the fair BaseRate →

How this hospital compares to other IN hospitals

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

Cheapest $10,414 Priciest $28,897

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

A fair price for a Hip or knee replacement (inpatient stay) is about $26,073 (about 1.9× the $14,044 Medicare rate). St Mary Medical Center Inc charges insurers about $28,897, or about $33,527 in cash — about the fair price. Located in Hobart, IN.

What each insurance company pays

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

5 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	$24,823 - $28,897	177%
Blue Cross Blue Shieldmajor	$14,927 - $40,765	106%
Aetnamajor	$45,720 - $47,134	326%
Cignamajor	$22,352 - $30,477	159%
Humanamajor	$17,842 - $19,289	127%
Ambetter (Centene)	$14,927	106%
+ 12 smaller / regional plans	$14,927 - $40,765

Government programs also on file: Medicare, Military & VA.

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 (about 33,527), 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 St Mary Medical Center Inc 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 St Mary Medical Center Inc

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

Putnam County Hospital · Greencastle $10,414
Norton Scott Hospital · Scottsburg $12,000
Pinnacle Hospital · Crown Point $12,487
Schneck Medical Center · Seymour $12,648
Ascension St Vincent Warrick · Boonville $13,590
Ascension St Vincent Salem · Salem $13,700
Goshen Hospital · Goshen $13,740
Ascension St Vincent Evansville · Evansville $13,833

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