CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Jefferson Abington Hospital

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$18,336

about 1.3× the $14,044 Medicare rate · typically $15,282–$25,933

modeled estimate · not a bill or quote

What this hospital charges insurers

$23,496

Above the fair price

about $5,160 over the fair price · 1.7× Medicare

Medicare pays $14,044 Fair price $18,336 This hospital $23,496 Cash price $17,550

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 $23,496

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 $18,336 (about 1.3× the $14,044 Medicare rate). Jefferson Abington Hospital charges insurers about $23,496, or about $17,550 in cash — above the fair price. Located in Abington, 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 $18,336. 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	$15,405 - $27,768	110%
Blue Cross Blue Shieldmajor	$16,945 - $33,248	121%
Aetnamajor	$16,329 - $30,036	116%
Cignamajor	$30,100 - $36,121	214%
Humanamajor	$15,713	112%
Ambetter (Centene)	$20,188	144%
Geisinger	$67,278	479%
UPMC Health Plan	$36,121	257%
+ 11 smaller / regional plans	$15,103 - $32,023

Government programs also on file: Medicare, Military & VA.

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 17,550), 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 Jefferson Abington Hospital 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 Jefferson Abington Hospital

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

Chan Soon- Shiong Medical Center at Windber · Windber $13,221
Penn State Health Lancaster Medical Center · Lancaster $13,535
Meadville Medical Center · Meadville $13,726
Allegheny Valley Hospital · Natrona $13,765
Canonsburg General Hospital · Canonsburg $13,776
Advanced Surgical Hospital · Washington $13,991
Ahn Wexford Hospital · Wexford $14,185
Punxsutawney Area Hospital · Punxsutawney $14,210

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