Hip or knee replacement (inpatient stay)
Facility: Shore Medical Center
Billing Code: 470 (MS-DRG)
This hospital's typical commercial price is $16,172 compared to the $18,385 fair price benchmark.
3-Star CMS clinical quality rating paired with 0.88× fair market pricing.
One of the lower prices — 6 of 8 other NJ hospitals charge more for the same procedure.
Black dot = this hospital, among the 9 NJ hospitals with a price for this procedure. Full list below.
A fair price for a Hip or knee replacement (inpatient stay) is about $18,385 (about 1.3× the $14,044 Medicare rate). Shore Medical Center charges insurers about $16,172 — below the fair price — a good deal. Located in Somers Point, NJ.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
3 of 6 major insurers have a published price at this hospital
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 |
|---|---|---|
| Blue Cross Blue Shieldmajor | $16,172 | 115% |
| Aetnamajor | $16,172 - $45,283 | 115% |
| Cignamajor | $20,253 | 144% |
| AmeriHealth | $13,590 - $16,172 | 97% |
| Clover Health | $16,172 | 115% |
| + 1 smaller / regional plan | $16,172 - $29,991 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Shore Medical Center
Compare: Hip or knee replacement (inpatient stay) at other NJ hospitals
- Valley Hospital · Paramus $15,142
- Cape Regional Medical Center Inc · Cape May Court House $16,041
- Carewell Health Medical Center · East Orange $16,253
- Southern Ocean Medical Center · Manahawkin $17,238
- Riverview Medical Center · Red Bank $17,275
- Bayshore Medical Center · Holmdel $17,391
- Jersey Shore University Medical Center · Neptune $18,886
- Jfk University Medical Center · Edison $18,963
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Shore Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $14,089
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 = $14,089).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Shore Medical Center'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 $18,385 Fair BaseRate ($14,044 Medicare)
Your bill ($38,813) is $20,428 above the denoised Fair BaseRate ($18,385) and 2.8× the $14,044 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.