CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Southcoast Hospitals Group

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$17,254

about 1.2× the $14,044 Medicare rate · typically $16,948–$21,200

modeled estimate · not a bill or quote

What this hospital charges insurers

$17,635

About the fair price

about $381 over the fair price · 1.3× Medicare

Medicare pays $14,044 Fair price $17,254 This hospital $17,635 Cash price $27,484 Hospital's list price $54,967

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

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

Cheapest $12,252 Priciest $17,635

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

A fair price for a Hip or knee replacement (inpatient stay) is about $17,254 (about 1.2× the $14,044 Medicare rate). Southcoast Hospitals Group charges insurers about $17,635, or about $27,484 in cash — about the fair price. Located in Fall River, MA.

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	$17,548 - $41,722	125%
Blue Cross Blue Shieldmajor	$17,548 - $22,178	125%
Aetnamajor	$17,548 - $47,256	125%
Cignamajor	$36,935 - $42,994	263%
Priority Health	$42,454 - $49,418	302%
Tufts Health Plan	$7,818 - $36,020	56%
WellSense	$2,194 - $17,723	16%
+ 8 smaller / regional plans	$14,429 - $49,418

Government programs also on file: Medicare.

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 (about 27,484), 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 Southcoast Hospitals Group 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 Southcoast Hospitals Group

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

The Shriners' Hospital for Children - Boston · Boston $12,252
Beth Israel Deaconess Hospital - Milton · Milton $13,752
Metrowest Medical Center · Framingham $14,509
Heywood Hospital - · Gardner $16,386
Emerson Hospital - · W Concord $16,445
Winchester Hospital · Winchester $16,517
Anna Jaques Hospital · Newburyport $16,740
Holyoke Medical Center · Holyoke $16,772

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