CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: St Mary Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$18,243
about 1.3× the $14,044 Medicare rate · typically $14,987–$26,092
modeled estimate · not a bill or quote
What this hospital charges insurers
$30,024
Above the fair price
about $11,781 over the fair price · 2.1× Medicare
Medicare pays $14,044 Fair price $18,243 This hospital $30,024 Cash price $50,068

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 $30,024

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 $18,243 (about 1.3× the $14,044 Medicare rate). St Mary Medical Center charges insurers about $30,024, or about $50,068 in cash — above the fair price. Located in Langhorne, 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 $18,243. 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.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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 $32,493 231%
Blue Cross Blue Shieldmajor $15,015 - $43,219 107%
Aetnamajor $16,248 - $43,443 116%
Cignamajor $15,496 - $39,342 110%
Ambetter (Centene) $27,402 195%
AmeriHealth $30,024 214%
GEHA $32,493 231%
Oscar Health $27,632 197%
UPMC Health Plan $39,342 280%
+ 7 smaller / regional plans $13,816 - $36,683
Government programs also on file: Medicare.
Excludes 2 rental-network / third-party entries (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.

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Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals