Price AtlasInteractive atlas · All states · techysurgeon.comProgress West Hospital: what a joint replacement costs
O Fallon, MO 63368 · CMS Certification Number 260219. What Medicare pays this hospital for knee, hip and shoulder replacement, what it lists, how it compares, and what a surgery center nearby is paid.
Medicare prices at Progress West Hospital
| Operation | Inpatient avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $15,256 | $53,173 | 3.5× | $11,554 |
| Shoulder replacement | — | — | — | $16,551 |
Commercial negotiated rates (beta)
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $23,993 | 1.6× | $18,710–$37,912 | 8 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Humana | $37,912 | 2.5× | 1 |
| UnitedHealthcare | $31,285 | 2.1× | 1 |
| Elevance/Anthem/Empire | $29,751 | 2.0× | 1 |
| Aetna | $24,702 | 1.6× | 1 |
| Sarah Bush Lincoln | $23,284 | 1.5× | 1 |
| Consociate | $21,765 | 1.4× | 1 |
| Health Alliance | $21,414 | 1.4× | 1 |
| Cigna | $18,710 | 1.2× | 1 |
From the hospital's price-transparency file (2025-12-15); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2025-12-15); commercial plans, dollar-amount contracts only.
Quality
Complications after hip or knee replacement: 3.3% (no different from the national rate). Readmissions: 6%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 76 beds
Missouri has a certificate-of-need program that does not cover surgery centers.
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Questions
How much does Medicare pay Progress West Hospital for a knee or hip replacement?
In 2024 the average total payment to Progress West Hospital for an inpatient hip or knee replacement stay was $15,256 (MS-DRG 470, 16 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,554 per outpatient case (APC 5115, 140 cases).
What is Progress West Hospital's list price for a joint replacement?
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $53,173, 3.5× the average total payment for a Medicare stay. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Is a knee replacement cheaper at a surgery center near Progress West Hospital?
Yes for Medicare facility payments. St. Peter's Surgery Center, LLC, an orthopedic surgery center 7.1 mi away, is paid about $8,800 by Medicare for a knee replacement (CPT 27447), $6,456 less than an inpatient stay at Progress West Hospital. Not every patient is a surgery-center candidate.
How does Progress West Hospital compare with other Missouri hospitals?
Progress West Hospital's average total payment per Medicare stay is higher than 72% of the 32 Missouri hospitals that report inpatient hip or knee replacement.
What do commercial insurers pay Progress West Hospital for a hip or knee replacement?
From the hospital's own price-transparency file, commercial plans' negotiated rates for MS-DRG 470 have a median of $23,993 across 8 insurers, ranging from $18,710 to $37,912.