CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Spotsylvania Regional Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$24,728

about 1.8× the $14,044 Medicare rate · typically $16,118–$34,037

modeled estimate · not a bill or quote

What this hospital charges insurers

$20,264

Below the fair price — a good deal

about $4,464 under the fair price · 1.4× Medicare

Medicare pays $14,044 Fair price $24,728 This hospital $20,264

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 $20,264

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 $24,728 (about 1.8× the $14,044 Medicare rate). Spotsylvania Regional Medical Center charges insurers about $20,264 — below the fair price — a good deal. Located in Fredericksburg, 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	$3,382 - $31,270	24%
Blue Cross Blue Shieldmajor	$2,303 - $29,075	16%
Aetnamajor	$15,544 - $47,348	111%
Cignamajor	$15,523 - $25,224	111%
Humanamajor	$15,219	108%
Bright Health	$14,920 - $20,264	106%
Devoted Health	$15,523	111%
Sentara	$15,219 - $32,729	108%
+ 4 smaller / regional plans	$15,523 - $15,979

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 Spotsylvania Regional 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 Spotsylvania Regional 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.