CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Medical City Plano

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$21,413

about 1.5× the $14,044 Medicare rate · typically $15,380–$26,279

modeled estimate · not a bill or quote

What this hospital charges insurers

$20,607

About the fair price

about $806 under the fair price · 1.5× Medicare

Medicare pays $14,044 Fair price $21,413 This hospital $20,607

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

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

Cheapest $8,277 Priciest $20,607

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

A fair price for a Hip or knee replacement (inpatient stay) is about $21,413 (about 1.5× the $14,044 Medicare rate). Medical City Plano charges insurers about $20,607 — about the fair price. Located in Plano, TX.

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	$4,100 - $55,235	29%
Blue Cross Blue Shieldmajor	$16,062 - $54,611	114%
Aetnamajor	$2,599 - $15,899	19%
Cignamajor	$16,430 - $102,602	117%
Humanamajor	$15,786 - $56,866	112%
Amerigroup	$16,108	115%
Devoted Health	$16,430	117%
Fidelis Care	$18,202	130%
Healthcare Highways	$6,200 - $60,000	44%
Independent Health	$16,430	117%
Molina	$17,558 - $33,808	125%
Oscar Health	$21,955	156%
WellCare	$16,108	115%
WellMed	$16,060	114%
+ 13 smaller / regional plans	$16,108 - $36,083

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

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 Medical City Plano 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 Medical City Plano

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

Childrens Medical Ctr of Dallas · Dallas $8,277
Childrens Medical Center Plano · Plano $8,277
Yoakum Community Hospital · Yoakum $10,446
Coon Memorial Hospital · Dalhart $11,018
Dell Seton Med Center at the University of Tx · Austin $11,474
Northwest Hills Surgical Hospital · Austin $11,474
Ascension Seton Highland Lakes · Burnet $11,474
Ascension Seton Edgar B Davis · Luling $11,474

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