CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Legacy Mount Hood Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$22,458

about 1.6× the $14,044 Medicare rate · typically $17,935–$33,013

modeled estimate · not a bill or quote

What this hospital charges insurers

$20,333

About the fair price

about $2,125 under the fair price · 1.4× Medicare

Medicare pays $14,044 Fair price $22,458 This hospital $20,333

How we calculate the fair BaseRate →

How this hospital compares to other OR hospitals

On the higher side — 7 of 8 other OR hospitals charge less.

Cheapest $14,718 Priciest $20,378

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

A fair price for a Hip or knee replacement (inpatient stay) is about $22,458 (about 1.6× the $14,044 Medicare rate). Legacy Mount Hood Medical Center charges insurers about $20,333 — about the fair price. Located in Gresham, OR.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser 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	$18,868 - $43,244	134%
Blue Cross Blue Shieldmajor	$19,234 - $39,709	137%
Aetnamajor	$19,234 - $53,045	137%
Cignamajor	$20,150	143%
Humanamajor	$19,234	137%
Kaiser Permanentemajor	$18,318 - $36,636	130%
Devoted Health	$19,234	137%
Health Net	$19,417	138%
Moda Health	$20,516 - $46,713	146%
PacificSource	$19,783 - $36,823	141%
+ 6 smaller / regional plans	$18,868 - $33,939

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 Legacy Mount Hood 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 Legacy Mount Hood Medical Center

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

Shriners Hospital for Children - Portland · Portland $14,718
Santiam Hospital & Clinics · Stayton $16,389
St Charles Medical Center - Bend · Bend $16,774
Mid-Columbia Medical Center · The Dalles $16,845
Providence Newberg Medical Center · Newberg $17,666
Legacy Meridian Park Medical Center · Tualatin $18,333
Sky Lakes Medical Center · Klamath Falls $19,733
Providence Medford Medical Center · Medford $20,378

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