CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: St Anthony Hospital

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$30,883

about 2.2× the $14,044 Medicare rate · typically $20,019–$37,975

modeled estimate · not a bill or quote

What this hospital charges insurers

$30,981

About the fair price

about $98 over the fair price · 2.2× Medicare

Medicare pays $14,044 Fair price $30,883 This hospital $30,981

How we calculate the fair BaseRate →

How this hospital compares to other WA hospitals

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

Cheapest $11,313 Priciest $30,981

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

A fair price for a Hip or knee replacement (inpatient stay) is about $30,883 (about 2.2× the $14,044 Medicare rate). St Anthony Hospital charges insurers about $30,981 — about the fair price. Located in Gig Harbor, WA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 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	$15,665 - $44,675	112%
Blue Cross Blue Shieldmajor	$15,975 - $51,677	114%
Aetnamajor	$15,975 - $49,296	114%
Cignamajor	$36,315	259%
Humanamajor	$16,595	118%
Kaiser Permanentemajor	$15,510 - $43,887	110%
Amerigroup	$16,595	118%
Molina	$16,750 - $29,701	119%
+ 6 smaller / regional plans	$15,510 - $42,931

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 St Anthony Hospital 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 St Anthony Hospital

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

Prosser Memorial Hospital · Prosser $11,313
Island Hospital · Anacortes $15,159
Trios Health · Kennewick $15,607
Valley Medical Center · Renton $17,979
Providence St Mary Medical Center · Walla Walla $18,017
Providence Centralia Hospital · Centralia $18,809
Kadlec Regional Medical Center · Richland $19,278
Shriners Hospital for Children · Spokane $19,823

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