Hip or knee replacement (inpatient stay)
Facility: SSM Health St Mary's Hospital - Madison
Billing Code: 470 (MS-DRG)
Highest price of the 9 WI hospitals we have prices for — worth calling around.
Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.
A fair price for a Hip or knee replacement (inpatient stay) is about $21,945 (about 1.6× the $14,044 Medicare rate). SSM Health St Mary's Hospital - Madison charges insurers about $38,605 — well above the fair price. Located in Madison, WI.
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 $21,945. 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.
1 of 6 major insurers have a published price at this hospital
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 |
|---|---|---|
| Blue Cross Blue Shieldmajor | $39,135 - $48,743 | 279% |
| Dean Health Plan | $14,710 | 105% |
| Molina | $11,033 | 79% |
| + 3 smaller / regional plans | $14,710 - $59,748 |
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.
Other Procedures at SSM Health St Mary's Hospital - Madison
Compare: Hip or knee replacement (inpatient stay) at other WI hospitals
- Orthopaedic Hospital of Wisconsin · Glendale $13,222
- Thedacare Regional Medical Center - Appleton Inc · Appleton $13,348
- Sauk Prairie Hospital · Prairie Du Sac $13,634
- Oakleaf Surgical Hospital · Altoona $13,660
- The Monroe Clinic · Monroe $13,719
- Mile Bluff Medical Center · Mauston $13,872
- Ascension Sacred Heart Rehabilitation Hospital · Mequon $15,202
- Ascension Columbia St Marys Hospital Milwaukee · Milwaukee $15,215
Insurance negotiated median for the same procedure, sorted lowest first.