CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Saint Alphonsus Medical Center Ontario

Billing Code: 470 (MS-DRG)

The BaseRate · fair price medium confidence

A fair price for this

$20,062

about 1.4× the $14,044 Medicare rate · typically $10,660–$35,616

modeled estimate · not a bill or quote

What this hospital charges insurers

$35,615

Well above the fair price

about $15,553 over the fair price · 2.5× Medicare

Medicare pays $14,044 Fair price $20,062 This hospital $35,615 Cash price $33,259

How we calculate the fair BaseRate →

How this hospital compares to other OR hospitals

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

Cheapest $14,718 Priciest $35,615

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 $20,062 (about 1.4× the $14,044 Medicare rate). Saint Alphonsus Medical Center Ontario charges insurers about $35,615, or about $33,259 in cash — well above the fair price. Located in Ontario, OR.

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 $20,062. 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.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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	$16,818	120%
Blue Cross Blue Shieldmajor	$16,818 - $36,086	120%
Aetnamajor	$17,322	123%
Moda Health	$25,000 - $30,890	178%
SelectHealth	$31,818 - $35,196	227%
+ 5 smaller / regional plans	$17,490 - $36,261

Government programs also on file: Medicare.

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 (about 33,259), 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 Saint Alphonsus Medical Center Ontario 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 Saint Alphonsus Medical Center Ontario

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
Legacy Mount Hood Medical Center · Gresham $20,333

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