CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Adventist Health Portland

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$22,562

about 1.6× the $14,044 Medicare rate · typically $17,998–$34,472

modeled estimate · not a bill or quote

What this hospital charges insurers

$25,217

About the fair price

about $2,655 over the fair price · 1.8× Medicare

Medicare pays $14,044 Fair price $22,562 This hospital $25,217 Cash price $31,545 Hospital's list price $98,577

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 $25,217

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 $22,562 (about 1.6× the $14,044 Medicare rate). Adventist Health Portland charges insurers about $25,217, or about $31,545 in cash — about the fair price. Located in Portland, 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	$17,343 - $41,815	123%
Blue Cross Blue Shieldmajor	$16,897 - $34,556	120%
Aetnamajor	$51,887	369%
Cignamajor	$24,169	172%
Humanamajor	$16,688 - $17,343	119%
Kaiser Permanentemajor	$16,361 - $29,007	116%
Health Net	$18,815 - $31,055	134%
Moda Health	$17,343 - $48,030	123%
+ 11 smaller / regional plans	$11,551 - $86,748

Excludes 6 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 31,545), 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 Adventist Health Portland 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 Adventist Health Portland

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.