CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Southern Ocean Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$23,633

about 1.7× the $14,044 Medicare rate · typically $17,358–$35,377

modeled estimate · not a bill or quote

What this hospital charges insurers

$17,238

Below the fair price — a good deal

about $6,395 under the fair price · 1.2× Medicare

Medicare pays $14,044 Fair price $23,633 This hospital $17,238 Cash price $13,672

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

A typical price — 5 charge more and 3 charge less, among the 9 NJ hospitals compared.

Cheapest $15,142 Priciest $19,104

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 $23,633 (about 1.7× the $14,044 Medicare rate). Southern Ocean Medical Center charges insurers about $17,238, or about $13,672 in cash — below the fair price — a good deal. Located in Manahawkin, NJ.

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	$15,603 - $71,843	111%
Blue Cross Blue Shieldmajor	$14,860	106%
Aetnamajor	$14,860 - $59,795	106%
Cignamajor	$54,811 - $62,944	390%
Amerigroup	$14,860	106%
AmeriHealth	$14,047	100%
Clover Health	$16,346	116%
WellCare	$14,860	106%
+ 5 smaller / regional plans	$6,542 - $67,659

Government programs also on file: 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 13,672), 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 Southern Ocean Medical Center 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 Southern Ocean Medical Center

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

Valley Hospital · Paramus $15,142
Shore Medical Center · Somers Point $15,215
Carewell Health Medical Center · East Orange $16,253
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
Deborah Heart and Lung Center · Browns Mills $19,104

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