CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: SSM Health St Anthony Hospital - Midwest

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$19,833

about 1.4× the $14,044 Medicare rate · typically $15,433–$25,234

modeled estimate · not a bill or quote

What this hospital charges insurers

$19,707

About the fair price

about $126 under the fair price · 1.4× Medicare

Medicare pays $14,044 Fair price $19,833 This hospital $19,707

How we calculate the fair BaseRate →

How this hospital compares to other OK hospitals

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

Cheapest $9,928 Priciest $19,707

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

A fair price for a Hip or knee replacement (inpatient stay) is about $19,833 (about 1.4× the $14,044 Medicare rate). SSM Health St Anthony Hospital - Midwest charges insurers about $19,707 — about the fair price. Located in Midwest City, OK.

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✓ Cigna✓ Humana AetnaKaiser 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	$14,636 - $18,067	104%
Blue Cross Blue Shieldmajor	$14,636 - $40,568	104%
Cignamajor	$23,927	170%
Humanamajor	$14,885	106%
Ambetter (Centene)	$19,759	141%
Health Net	$21,282	152%
Medica	$21,253	151%
Oscar Health	$19,655	140%
+ 5 smaller / regional plans	$14,636 - $28,540

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

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, 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 SSM Health St Anthony Hospital - Midwest 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 SSM Health St Anthony Hospital - Midwest

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

Alliancehealth Madill · Madill $9,928
Ascension St John Broken Arrow · Broken Arrow $11,017
Ascension St John Sapulpa · Sapulpa $11,017
St John Owasso · Owasso $11,813
Ascension St John Jane Phillips · Bartlesville $11,916
Ascension St John Medical Center · Tulsa $12,322
Oklahoma Surgical Hospital, LLC · Tulsa $12,956
McCurtain Memorial Hospital · Idabel $13,455

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