CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Highpoint Health-Sumner With Ascension Saint Thoma

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$16,734
about 1.2× the $14,044 Medicare rate · typically $13,842–$19,862
modeled estimate · not a bill or quote
What this hospital charges insurers
$13,369
Below the fair price — a good deal
about $3,365 under the fair price · 1.0× Medicare
Medicare pays $14,044 Fair price $16,734 This hospital $13,369 Cash price $24,313 Hospital's list price $104,348

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

A typical price — 4 charge more and 4 charge less, among the 9 TN hospitals compared.

Cheapest $7,429 Priciest $14,012

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

A fair price for a Hip or knee replacement (inpatient stay) is about $16,734 (about 1.2× the $14,044 Medicare rate). Highpoint Health-Sumner With Ascension Saint Thoma charges insurers about $13,369, or about $24,313 in cash — below the fair price — a good deal. Located in Gallatin, TN.

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✓ Cigna✓ Humana AetnaKaiser 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 $12,254 - $31,107 87%
Blue Cross Blue Shieldmajor $12,733 - $33,070 91%
Cignamajor $19,489 - $21,478 139%
Humanamajor $12,733 91%
Ambetter (Centene) $25,829 184%
Amerigroup $12,733 91%
Cigna HealthSpring $13,369 95%
Devoted Health $13,115 93%
Health Net $16,500 117%
+ 3 smaller / regional plans $12,733 - $13,497
Government programs also on file: Medicare, Military & VA.

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Facility Profile & Credentials

  • Address: 555 Hartsville Pike, Gallatin, TN 37066
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals