CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: PAM Specialty Hospital of Wilkes-Barre

Billing Code: 470 (MS-DRG)

The BaseRate · fair price medium confidence
A fair price for this
$27,391
about 2.0× the $14,044 Medicare rate · typically $12,327–$48,341
modeled estimate · not a bill or quote
What this hospital charges insurers
$31,802
Above the fair price
about $4,411 over the fair price · 2.3× Medicare
Medicare pays $14,044 Fair price $27,391 This hospital $31,802

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 $31,802

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 $27,391 (about 2.0× the $14,044 Medicare rate). PAM Specialty Hospital of Wilkes-Barre charges insurers about $31,802 — above the fair price. Located in Wilkes-Barre, 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 $27,391. 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.

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

✓ Blue Cross Blue Shield✓ Aetna UnitedHealthcareCignaHumanaKaiser 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
Blue Cross Blue Shieldmajor $29,337 209%
Aetnamajor $31,802 226%
Ambetter (Centene) $31,802 226%
AmeriHealth $31,802 226%
Geisinger $32,438 231%
+ 3 smaller / regional plans $31,802
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: 575 North River St, Wilkes-Barre, PA 18764
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL