CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Ascension Saint Thomas Hospital

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$13,813

about 1.0× the $14,044 Medicare rate · typically $10,948–$18,223

modeled estimate · not a bill or quote

What this hospital charges insurers

$13,288

About the fair price

about $525 under the fair price · 0.9× Medicare

Medicare pays $14,044 Fair price $13,813 This hospital $13,288

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

A typical price — 5 charge more and 3 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 $13,813 (about 1.0× the $14,044 Medicare rate). Ascension Saint Thomas Hospital charges insurers about $13,288 — 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	$11,485 - $15,974	82%
Blue Cross Blue Shieldmajor	$12,192 - $56,674	87%
Aetnamajor	$11,957 - $43,688	85%
Cignamajor	$9,450 - $26,957	67%
Humanamajor	$11,267 - $11,723	80%
Ambetter (Centene)	$15,240	109%
Amerigroup	$7,610 - $12,075	54%
Cigna HealthSpring	$11,723	83%
Oscar Health	$8,150 - $8,394	58%
+ 8 smaller / regional plans	$8,944 - $27,839

Government programs also on file: Medicare, Military & VA.

Excludes 1 rental-network / third-party entry (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 Ascension Saint Thomas Hospital 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 Ascension Saint Thomas Hospital

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
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
Tennova Healthcare-Jefferson Memorial Hospital · Jefferson City $14,012

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