CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Pennsylvania Hospital

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$19,503
about 1.4× the $14,044 Medicare rate · typically $15,487–$28,816
modeled estimate · not a bill or quote
What this hospital charges insurers
$26,583
Above the fair price
about $7,080 over the fair price · 1.9× Medicare
Medicare pays $14,044 Fair price $19,503 This hospital $26,583

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

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

Cheapest $13,221 Priciest $26,583

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

A fair price for a Hip or knee replacement (inpatient stay) is about $19,503 (about 1.4× the $14,044 Medicare rate). Pennsylvania Hospital charges insurers about $26,583 — above the fair price. Located in Philadelphia, PA.

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 $19,503. 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.

5 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 $3,308 - $43,735 24%
Blue Cross Blue Shieldmajor $16,173 - $45,100 115%
Aetnamajor $17,143 - $34,524 122%
Cignamajor $16,658 - $40,661 119%
Humanamajor $16,658 119%
Clover Health $17,143 122%
Geisinger $16,658 - $58,146 119%
HealthPartners $16,658 119%
Oscar Health $31,393 224%
UPMC Health Plan $16,173 115%
+ 18 smaller / regional plans $7,452 - $52,122
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

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: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals