Price AtlasInteractive atlas · All states · techysurgeon.comSt Clair Hospital: what a joint replacement costs
Pittsburgh, PA 15243 · CMS Certification Number 390228. 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 St Clair Hospital
| Operation | Inpatient avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $12,269 | $47,230 | 3.8× | $11,740 |
| Shoulder replacement | — | — | — | $16,610 |
| Hip replacement after a fracture (DRG 522) | $13,874 | $59,728 | 4.3× | — |
Commercial negotiated rates (beta)
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $26,040 | 2.1× | $19,467–$31,686 | 7 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Highmark BCBS | $31,686 | 2.6× | 1 |
| The Health Plan | $30,678 | 2.5× | 1 |
| Aetna | $27,356 | 2.2× | 1 |
| Cigna | $26,040 | 2.1× | 1 |
| Lantern | $25,906 | 2.1× | 1 |
| UnitedHealthcare | $24,644 | 2.0× | 1 |
| UPMC | $19,467 | 1.6× | 1 |
From the hospital's price-transparency file (2026-03-31); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-03-31); commercial plans, dollar-amount contracts only.
Quality
Complications after hip or knee replacement: 3% (no different from the national rate). Readmissions: 5.1%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 328 beds
Pennsylvania has no certificate-of-need law.
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Questions
How much does Medicare pay St Clair Hospital for a knee or hip replacement?
In 2024 the average total payment to St Clair Hospital for an inpatient hip or knee replacement stay was $12,269 (MS-DRG 470, 13 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,740 per outpatient case (APC 5115, 197 cases).
What is St Clair Hospital's list price for a joint replacement?
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $47,230, 3.8× 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 St Clair Hospital?
Yes for Medicare facility payments. Radiance - A Private Outpatient Surgery Center, an orthopedic surgery center 3.6 mi away, is paid about $8,254 by Medicare for a knee replacement (CPT 27447), $4,015 less than an inpatient stay at St Clair Hospital. Not every patient is a surgery-center candidate.
How does St Clair Hospital compare with other Pennsylvania hospitals?
St Clair Hospital's average total payment per Medicare stay is lower than 98% of the 64 Pennsylvania hospitals that report inpatient hip or knee replacement.
What do commercial insurers pay St Clair 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 $26,040 across 7 insurers, ranging from $19,467 to $31,686.