Hip or knee replacement (inpatient stay)
Facility: Physicians Regional Medical Center
Billing Code: 470 (MS-DRG)
This hospital's typical commercial price is $13,846 compared to the $15,830 fair price benchmark.
3-Star CMS clinical quality rating paired with 0.87× fair market pricing.
A typical price — 4 charge more and 4 charge less, among the 9 TN hospitals compared.
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 $15,830 (about 1.1× the $14,044 Medicare rate). Physicians Regional Medical Center charges insurers about $13,846 — below the fair price — a good deal. Located in Powell, 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
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 | $1,459 - $15,250 | 10% |
| Blue Cross Blue Shieldmajor | $7,899 - $35,463 | 56% |
| Aetnamajor | $13,846 - $18,446 | 99% |
| Humanamajor | $13,412 | 95% |
| Ambetter (Centene) | $26,672 | 190% |
| Amerigroup | $7,422 - $14,114 | 53% |
| Cigna HealthSpring | $13,846 | 99% |
| Devoted Health | $14,446 | 103% |
| WellCare | $14,196 | 101% |
| + 4 smaller / regional plans | $12,499 - $26,672 |
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.
Other Procedures at Physicians Regional Medical Center
Compare: Hip or knee replacement (inpatient stay) at other TN hospitals
- Unity Medical Center · Manchester $7,429
- Ascension Saint Thomas Hospital · Nashville $12,192
- Southern Tennessee Regional Health System Winchest · Winchester $13,087
- Highpoint Health-Sumner With Ascension Saint Thoma · Gallatin $13,369
- Dekalb Community Hospital · Smithville $13,948
- Tennova Healthcare-Jefferson Memorial Hospital · Jefferson City $14,012
- Parkwest Medical Center · Knoxville $14,057
- Starr Regional Medical Center Athens · Athens $14,099
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Physicians Regional Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $12,062
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $12,062).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Physicians Regional Medical Center's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $15,830 Fair BaseRate ($14,044 Medicare)
Your bill ($33,230) is $17,400 above the denoised Fair BaseRate ($15,830) and 2.4× the $14,044 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.