CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: North Austin Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$14,942
about 1.1× the $14,044 Medicare rate · typically $9,576–$18,039
modeled estimate · not a bill or quote
What this hospital charges insurers
$18,405
Above the fair price
about $3,463 over the fair price · 1.3× Medicare
Medicare pays $14,044 Fair price $14,942 This hospital $18,405

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 $18,405

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 $14,942 (about 1.1× the $14,044 Medicare rate). North Austin Medical Center charges insurers about $18,405 — above the fair price. Located in Austin, TX.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $14,942. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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 $2,781 - $27,735 20%
Blue Cross Blue Shieldmajor $16,731 - $56,272 119%
Aetnamajor $3,463 - $17,903 25%
Cignamajor $4,236 - $38,603 30%
Humanamajor $17,903 127%
Devoted Health $17,066 122%
Healthcare Highways $24,219 - $24,711 172%
Independent Health $18,572 132%
Moda Health $14,382 - $26,630 102%
Molina $18,237 130%
Oscar Health $14,968 - $16,506 107%
WellCare $18,572 132%
WellMed $16,514 118%
+ 31 smaller / regional plans $15,058 - $31,892
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

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.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals