CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: San Juan Regional Medical Center Inc

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$17,634

about 1.3× the $14,044 Medicare rate · typically $14,843–$22,297

modeled estimate · not a bill or quote

Medicare pays $14,044 Fair price $17,634 Cash price $38,060 Hospital's list price $76,120

How we calculate the fair BaseRate →

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✓ Aetna✓ Cigna✓ Humana Blue Cross Blue ShieldKaiser 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	$25,233 - $58,003	180%
Aetnamajor	$68,508	488%
Cignamajor	$59,282	422%
Humanamajor	$15,905 - $60,896	113%
Health Net	$60,896	434%
Presbyterian	$15,182 - $33,561	108%
+ 7 smaller / regional plans	$6,775 - $60,896

Excludes 3 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 38,060), 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 San Juan Regional 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 San Juan Regional Medical Center Inc

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

Alta Vista Regional Hospital · Las Vegas $13,883
Christus St Vincent Regional Medical Center · Santa Fe $13,892
Holy Cross Hospital A Div of Taos Health Systems · Taos $14,747
Mountain View Regional Medical Center · Las Cruces $15,397
Eastern New Mexico Medical Center · Roswell $15,647
Carlsbad Medical Center · Carlsbad $15,892
Covenant Health Hobbs Hospital · Hobbs $17,989
Presbyterian Hospital · Albuquerque $19,013

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