CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Sentara Northern Virginia Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$24,879

about 1.8× the $14,044 Medicare rate · typically $16,132–$34,484

modeled estimate · not a bill or quote

What this hospital charges insurers

$24,766

About the fair price

about $113 under the fair price · 1.8× Medicare

Medicare pays $14,044 Fair price $24,879 This hospital $24,766

How we calculate the fair BaseRate →

How this hospital compares to other VA hospitals

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

Cheapest $8,878 Priciest $24,766

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

A fair price for a Hip or knee replacement (inpatient stay) is about $24,879 (about 1.8× the $14,044 Medicare rate). Sentara Northern Virginia Medical Center charges insurers about $24,766 — about the fair price. Located in Woodbridge, VA.

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	$16,208 - $31,181	115%
Blue Cross Blue Shieldmajor	$16,169 - $27,817	115%
Aetnamajor	$15,745	112%
Cignamajor	$20,230 - $21,989	144%
Humanamajor	$15,899	113%
Sentara	$15,745 - $29,033	112%

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 Sentara Northern Virginia 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 Sentara Northern Virginia Medical Center

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

Carilion Stonewall Jackson Hospital · Lexington $8,878
Childrens Hospital of the Kings Daughters Inc · Norfolk $11,164
Sentara Rmh Medical Center · Harrisonburg $14,457
Sovah Health Danville · Danville $14,523
Clinch Valley Medical Center · Richlands $14,645
Lewisgale Hospital Alleghany · Low Moor $14,889
Sentara Halifax Regional Hospital · South Boston $14,993
Lewisgale Hospital Pulaski · Pulaski $15,116

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