CMS Price Transparency Data
Hip or knee replacement (inpatient stay)
Facility: Physicians Care Surgical Hospital
Billing Code: 470 (MS-DRG)
The BaseRate · fair price medium confidence
A fair price for this
$20,031
about 1.4× the $14,044 Medicare rate · typically $11,690–$58,605
modeled estimate · not a bill or quote
Medicare pays $14,044 Fair price $20,031 Hospital's list price $7,662
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 | $12,772 - $27,099 | 91% |
| Blue Cross Blue Shieldmajor | $12,772 - $23,941 | 91% |
| Aetnamajor | $12,772 - $23,230 | 91% |
| Cignamajor | $12,772 - $18,977 | 91% |
| Humanamajor | $12,772 | 91% |
| AmeriHealth | $18,753 | 134% |
| GEHA | $23,230 | 165% |
| HealthPartners | $18,977 | 135% |
| UPMC Health Plan | $19,295 | 137% |
| + 51 smaller / regional plans | $2,850 - $27,099 |
Government programs also on file: Medicare, Medicaid, Military & VA.
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
Other Procedures at Physicians Care Surgical 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.