CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Elmhurst Hospital Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$27,188
about 1.9× the $14,044 Medicare rate · typically $17,837–$47,283
modeled estimate · not a bill or quote
What this hospital charges insurers
$40,494
Above the fair price
about $13,306 over the fair price · 2.9× Medicare
Medicare pays $14,044 Fair price $27,188 This hospital $40,494

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

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

Cheapest $11,437 Priciest $40,494

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

A fair price for a Hip or knee replacement (inpatient stay) is about $27,188 (about 1.9× the $14,044 Medicare rate). Elmhurst Hospital Center charges insurers about $40,494 — above the fair price. Located in Elmhurst, NY.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $27,188. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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 $33,779 - $51,457 241%
Blue Cross Blue Shieldmajor $40,494 288%
Aetnamajor $33,468 - $40,494 238%
Cignamajor $35,346 252%
Fidelis Care $40,494 - $57,502 288%
Oscar Health $17,861 127%
WellCare $41,102 293%
+ 11 smaller / regional plans $23,671 - $42,114
Government programs also on file: Military & VA.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 79-01 Broadway, Elmhurst, NY 11373
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals