CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Baylor Scott & White the Heart Hospital Plano

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$20,832

about 1.5× the $14,044 Medicare rate · typically $15,898–$26,251

modeled estimate · not a bill or quote

What this hospital charges insurers

$20,430

About the fair price

about $402 under the fair price · 1.5× Medicare

Medicare pays $14,044 Fair price $20,832 This hospital $20,430

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 $20,430

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 $20,832 (about 1.5× the $14,044 Medicare rate). Baylor Scott & White the Heart Hospital Plano charges insurers about $20,430 — 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	$16,651 - $63,475	119%
Blue Cross Blue Shieldmajor	$15,203 - $30,493	108%
Aetnamajor	$14,479 - $34,763	103%
Cignamajor	$23,356 - $27,477	166%
Humanamajor	$14,479 - $34,953	103%
Ambetter (Centene)	$32,724	233%
Baylor Scott & White	$13,756 - $26,063	98%
Cigna HealthSpring	$15,203	108%
Health Net	$25,749	183%
+ 4 smaller / regional plans	$15,203 - $35,742

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 Baylor Scott & White the Heart Hospital 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 Baylor Scott & White the Heart Hospital 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.