CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Spartanburg Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$25,936

about 1.8× the $14,044 Medicare rate · typically $15,788–$30,557

modeled estimate · not a bill or quote

What this hospital charges insurers

$30,849

Above the fair price

about $4,913 over the fair price · 2.2× Medicare

Medicare pays $14,044 Fair price $25,936 This hospital $30,849

How we calculate the fair BaseRate →

How this hospital compares to other SC hospitals

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

Cheapest $10,535 Priciest $30,849

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

A fair price for a Hip or knee replacement (inpatient stay) is about $25,936 (about 1.8× the $14,044 Medicare rate). Spartanburg Medical Center charges insurers about $30,849 — above the fair price. Located in Spartanburg, SC.

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 $25,936. 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	$14,657 - $65,924	104%
Blue Cross Blue Shieldmajor	$14,331 - $62,530	102%
Aetnamajor	$14,799	105%
Cignamajor	$15,226 - $58,176	108%
Humanamajor	$14,230	101%
Devoted Health	$14,657	104%
Health Net	$58,735	418%
Molina	$14,941 - $30,862	106%
SelectHealth	$14,941 - $30,835	106%
WellCare	$14,941	106%
+ 2 smaller / regional plans	$14,941 - $46,785

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, 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 Spartanburg Medical Center 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 Spartanburg Medical Center

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

Prisma Health Tuomey Hospital · Sumter $10,535
Anmed Health · Anderson $11,193
Cannon Memorial Hospital · Pickens $11,420
McLeod Loris Hospital · Loris $13,303
MUSC Health Black River Medical Center · Cades $13,529
Aiken Regional Medical Center · Aiken $13,642
Cherokee Medical Center · Gaffney $13,809
Prisma Health Patewood Hospital · Greenville $14,493

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