CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: HCA Houston Healthcare Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$19,474

about 1.4× the $14,044 Medicare rate · typically $16,173–$25,105

modeled estimate · not a bill or quote

What this hospital charges insurers

$18,647

About the fair price

about $827 under the fair price · 1.3× Medicare

Medicare pays $14,044 Fair price $19,474 This hospital $18,647

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 $18,647

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 $19,474 (about 1.4× the $14,044 Medicare rate). HCA Houston Healthcare Medical Center charges insurers about $18,647 — about the fair price. Located in Houston, 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	$2,591 - $33,000	18%
Blue Cross Blue Shieldmajor	$15,916 - $42,082	113%
Aetnamajor	$13,211 - $27,933	94%
Cignamajor	$15,757 - $47,378	112%
Humanamajor	$15,423 - $28,297	110%
Amerigroup	$16,234	116%
Devoted Health	$16,234	116%
Healthcare Highways	$23,469	167%
Independent Health	$16,553	118%
Molina	$17,348 - $28,424	124%
Oscar Health	$15,598 - $22,549	111%
WellCare	$16,553	118%
WellMed	$15,757	112%
+ 10 smaller / regional plans	$16,075 - $26,964

Government programs also on file: Medicaid, 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 HCA Houston Healthcare 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 HCA Houston Healthcare Medical Center

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.