CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Tristar Skyline Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$15,783

about 1.1× the $14,044 Medicare rate · typically $13,895–$19,175

modeled estimate · not a bill or quote

What this hospital charges insurers

$16,679

About the fair price

about $896 over the fair price · 1.2× Medicare

Medicare pays $14,044 Fair price $15,783 This hospital $16,679

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

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

Cheapest $7,429 Priciest $16,679

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 $15,783 (about 1.1× the $14,044 Medicare rate). Tristar Skyline Medical Center charges insurers about $16,679 — about the fair price. Located in Nashville, TN.

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	$2,994 - $33,901	21%
Blue Cross Blue Shieldmajor	$7,585 - $66,535	54%
Aetnamajor	$16,515 - $47,887	118%
Cignamajor	$18,507 - $21,031	132%
Humanamajor	$16,352 - $24,242	116%
Ambetter (Centene)	$15,246 - $15,856	109%
Amerigroup	$16,352	116%
Bright Health	$15,814 - $19,605	113%
Cigna HealthSpring	$16,679	119%
Devoted Health	$16,679	119%
Oscar Health	$22,178	158%
WellCare	$16,842	120%
+ 12 smaller / regional plans	$2,300 - $17,987

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 Tristar Skyline 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 Tristar Skyline Medical Center

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

Unity Medical Center · Manchester $7,429
Southern Tennessee Regional Health System Winchest · Winchester $13,087
Parkwest Medical Center · Knoxville $13,222
Ascension Saint Thomas Hospital · Nashville $13,288
Highpoint Health-Sumner With Ascension Saint Thoma · Gallatin $13,369
Physicians Regional Medical Center · Powell $13,846
Dekalb Community Hospital · Smithville $13,948
Morristown Hamblen Hospital Association · Morristown $13,961

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