National price data · 1,518 hospitals
Total knee replacement cost
What a total knee replacement costs across the U.S. — and the fair price to aim for.
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
1.00×vs. Fair Market Price
Position vs. 1.00× Fair PriceRight at U.S. Average (0%)
1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.
Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.
Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety ScoreNot ScoredComposite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Behavioral Pricing FingerprintUpper-Quartile Spread · +81% Tail Jump
Wide Procedure Spread · Upper-Quartile Skew Pricer
This hospital prices routine shoppable procedures at 2.8× Medicare (median 1.45× Fair BaseRate) while upper-quartile commercial rates jump +81% to 2.63× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
#29 of 60 in NE · 46th State Percentile#2,805 of 3,385 in U.S. · 82nd National Percentile
Advantage
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.27× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 29% of shoppable procedures (44/100 Cash Honesty)
- CMS clinical safety score (68/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (50.1% AGB cap)
Watchout
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.1× markup over Medicare rates
- Commercial insurance median sits at 1.45× Fair BaseRate (2.8× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.63×) jump +81% above the median procedure ratio (Q50 1.45×)
- Unnegotiated chargemaster list prices average 11.4× Medicare (20¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
2.8× Medicare
Pre-scheduled outpatient procedures where patients can comparison-shop.
Back-Door Captive & ER0.75× Divergence
2.1× Medicare
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Quantile Tail Spread+81% Upper Tail
Q25 0.27× · Q50 1.45× · Q75 2.63×
Detects median-gaming when upper-quartile codes spike above the p50 median.
Select any lens to inspect department markups, federal cost accounting, or insurer discounts.
Department & Integrity Multiples (vs. CMS Medicare Cost Anchor)
Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×
Front-Door Shoppable CareFront-Door Shoppable
2.8× MedicareFair
Outpatient Surgery & ORBack-Door Captive
1.1× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
1.5× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
1.1× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
1.3× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.1× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
29% Cash Edge · 44/100Watchout
CMS Clinical Safety & Star ValueIntegrity & Outcomes
3 CMS · 68/100Fair
National Geographic Price Intelligence · 50-State + DC/PR Cartogram
National State Price Index Heatmap · Total knee replacement
State commercial price index vs. U.S. median (1.00×) and average Medicare multiple across all 53 priced states & territories
<0.93× Below Fair Price
0.93–1.05× Near Average
1.05–1.18× Elevated
>1.18× High-Cost State
AK0.67×
7.8× Med
ME0.35×
2.1× Med
WA1.61×
18.8× Med
ID0.40×
4.7× Med
MT0.99×
11.5× Med
ND1.07×
12.5× Med
MN0.95×
11.1× Med
WI1.10×
12.8× Med
MI0.94×
11.0× Med
VT0.35×
2.5× Med
NH1.83×
21.4× Med
OR1.31×
15.3× Med
NV0.78×
9.1× Med
WY0.35×
4.1× Med
SD0.98×
11.4× Med
IA0.35×
3.1× Med
IL1.02×
11.9× Med
IN1.63×
19.0× Med
OH0.93×
10.8× Med
PA0.99×
11.5× Med
NY0.94×
11.0× Med
MA1.38×
16.1× Med
CA1.21×
14.1× Med
UT1.85×
21.6× Med
CO0.96×
11.2× Med
NE0.93×
10.8× Med
MO0.97×
11.3× Med
KY0.94×
11.0× Med
WV0.95×
11.1× Med
VA1.13×
13.2× Med
MD1.20×
1.2× Med
NJ1.12×
13.1× Med
CT0.39×
4.6× Med
AZ1.01×
11.8× Med
NM0.98×
11.5× Med
KS0.86×
10.1× Med
AR0.93×
10.8× Med
TN0.93×
10.9× Med
NC0.94×
10.9× Med
SC1.10×
12.8× Med
DE1.29×
15.1× Med
DC0.98×
11.4× Med
RI1.46×
17.0× Med
OK1.19×
13.9× Med
LA0.88×
10.2× Med
MS1.07×
12.5× Med
AL0.88×
10.3× Med
GA0.88×
10.2× Med
HI1.10×
12.9× Med
TX0.98×
11.4× Med
FL1.04×
12.2× Med
PR0.77×
1.1× Med
IA0.35×3.1× MedME0.35×2.1× MedVT0.35×2.5× MedWY0.35×4.1× MedCT0.39×4.6× MedID0.40×4.7× MedAK0.67×7.8× MedPR0.77×1.1× MedNV0.78×9.1× MedKS0.86×10.1× MedAL0.88×10.3× MedGA0.88×10.2× MedLA0.88×10.2× MedAR0.93×10.8× MedNE0.93×10.8× MedOH0.93×10.8× MedTN0.93×10.9× MedKY0.94×11.0× MedMI0.94×11.0× MedNC0.94×10.9× MedNY0.94×11.0× MedMN0.95×11.1× MedWV0.95×11.1× MedCO0.96×11.2× MedMO0.97×11.3× MedDC0.98×11.4× MedNM0.98×11.5× MedSD0.98×11.4× MedTX0.98×11.4× MedMT0.99×11.5× MedPA0.99×11.5× MedAZ1.01×11.8× MedIL1.02×11.9× MedFL1.04×12.2× MedMS1.07×12.5× MedND1.07×12.5× MedHI1.10×12.9× MedSC1.10×12.8× MedWI1.10×12.8× MedNJ1.12×13.1× MedVA1.13×13.2× MedOK1.19×13.9× MedMD1.20×1.2× MedCA1.21×14.1× MedDE1.29×15.1× MedOR1.31×15.3× MedMA1.38×16.1× MedRI1.46×17.0× MedWA1.61×18.8× MedIN1.63×19.0× MedNH1.83×21.4× MedUT1.85×21.6× Med
5 Lowest-Price States (Confounder-Isolated Value Leaders)
5 Highest-Markup States (Strict Bill Audit Recommended)
The BaseRate high confidence
$13,081
the fair national price for a total knee replacement
typically $4,434–$21,833 across 1,518 hospitals · how we calculate it
modeled estimate · not a bill or quote
1,518
hospitals priced
51
states
4.9×
price spread — where shopping matters
11.7×
vs. Medicare
Across 1,518 hospitals in 51 states, a total knee replacement has a fair BaseRate of $13,081 and typically costs $4,434–$21,833. The cheapest state is ME; the priciest is UT.
Cheapest hospitals for a total knee replacement
- Tri Valley Health System · Cambridge, NE $2,117
- Central Montana Medical Center · Lewistown, MT $2,119
- Caribou Medical Center · Soda Springs, ID $2,126
- Clay County Hospital · Flora, IL $2,130
- Uc San Diego Health Hillcrest - Hillcrest Med Ctr · San Diego, CA $2,136
- Franklin Medical Center · Winnsboro, LA $2,137
- Manning Regional Healthcare Center · Manning, IA $2,151
- Memorial Medical Center · Port Lavaca, TX $2,219
- Harney District Hospital · Burns, OR $2,249
- Coffee Regional Medical Center, Inc · Douglas, GA $2,252
- Erlanger Medical Center · Chattanooga, TN $2,253
- Lincolnhealth · Damariscotta, ME $2,268
- Mainehealth Stephens Hospital · Norway, ME $2,268
- Sparrow Ionia Hospital · Ionia, MI $2,275
- Covenant Medical Center · Saginaw, MI $2,275
Total knee replacement cost by state
AK $9,052 6 hospitals AL $11,954 24 hospitals AR $12,541 16 hospitals AZ $13,700 35 hospitals CA $16,336 127 hospitals CO $12,977 28 hospitals CT $5,306 10 hospitals DC $13,266 2 hospitals DE $17,481 3 hospitals FL $14,107 87 hospitals GA $11,881 46 hospitals HI $14,933 6 hospitals IA $3,637 28 hospitals ID $5,476 9 hospitals IL $13,758 50 hospitals IN $22,000 40 hospitals KS $11,669 23 hospitals KY $12,748 18 hospitals LA $11,875 36 hospitals MA $18,646 20 hospitals ME $2,478 9 hospitals MI $12,722 34 hospitals MN $12,905 37 hospitals MO $13,155 28 hospitals MS $14,448 24 hospitals MT $13,382 4 hospitals NC $12,645 28 hospitals ND $14,537 13 hospitals NE $12,539 25 hospitals NH $24,814 8 hospitals NJ $15,153 37 hospitals NM $13,295 10 hospitals NV $10,577 16 hospitals NY $12,758 39 hospitals OH $12,512 88 hospitals OK $16,136 25 hospitals OR $17,728 13 hospitals PA $13,321 59 hospitals RI $19,705 4 hospitals SC $14,892 25 hospitals SD $13,253 7 hospitals TN $12,628 41 hospitals TX $13,252 166 hospitals UT $25,029 7 hospitals VA $15,341 48 hospitals VT $2,858 3 hospitals WA $21,833 32 hospitals WI $14,891 60 hospitals WV $12,868 9 hospitals WY $4,714 4 hospitals
Inline Bill X-Ray & 501(r) Calculator
501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 36.3%
Audit a Bill or Quote at U.S. Hospital Benchmark (Zero PHI Required)
Fair BaseRate™ $13,081
Medicare Rate $7,587
Self-Pay Cash Request Quote
Insurer Median $13,523
Pre-filled with U.S. Hospital Benchmark’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check
501(r) AGB Cap: $11,781 (274% FPL)
Statutory 501(r) AGB Cap Limits Bill to $11,781
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 = $11,781).
Step 2 · Cash vs. Insurance Arbitrage
Request Prompt-Pay Quote
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask U.S. Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Step 3 · Fair BaseRate Target
+$19,374 Above Fair BaseRate
Negotiate Toward $13,081 Fair BaseRate ($7,587 Medicare)
Your bill ($32,455) is $19,374 above the denoised Fair BaseRate ($13,081) and 4.3× the $7,587 Medicare rate.
1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.
Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Inpatient MS-DRG vs. Outpatient CPT Care-Setting Savings
Total Knee Arthroplasty (Replacement)DRG 470 vs CPT 27447
Inpatient: $51,826Outpatient: $16,444
Save $35,382 outpatient
Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.