Price AtlasInteractive atlas · All states · techysurgeon.comPrisma Health Oconee Memorial Hospital: what a joint replacement costs
Seneca, SC 29672 · CMS Certification Number 420009. 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 Prisma Health Oconee Memorial Hospital
| Operation | Inpatient avg total payment Medicare + patient share | List price | List ÷ total | Outpatient Medicare allowed |
|---|---|---|---|---|
| Hip or knee replacement | $15,660 | $91,630 | 5.9× | $11,979 |
| Shoulder replacement | — | — | — | $17,146 |
| Hip replacement after a fracture (DRG 522) | $19,530 | $86,691 | 4.4× | — |
Commercial negotiated rates (beta)
| MS-DRG 470 | Median across insurers | × Medicare total payment | Lowest–highest insurer | Insurers |
|---|---|---|---|---|
| Hip or knee replacement | $35,934 | 2.3× | $28,145–$48,773 | 6 |
| Insurer | Median negotiated, MS-DRG 470 | × Medicare total payment | Plans |
|---|---|---|---|
| Bluechoice | $48,773 | 3.1× | 1 |
| Cigna | $39,398 | 2.5× | 1 |
| Promise Health Plan | $37,614 | 2.4× | 1 |
| Preferred Administrators | $34,253 | 2.2× | 1 |
| Bob Jones Univ-Pai | $30,920 | 2.0× | 1 |
| BCBS South Carolina | $28,145 | 1.8× | 1 |
From the hospital's price-transparency file (2026-03-01); commercial plans, dollar-amount contracts only.
From the hospital's price-transparency file (2026-03-01); commercial plans, dollar-amount contracts only.
Quality
Complications after hip or knee replacement: 3.2% (no different from the national rate). Readmissions: 5.7%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 169 beds
South Carolina has a certificate-of-need program that does not cover surgery centers.
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Questions
How much does Medicare pay Prisma Health Oconee Memorial Hospital for a knee or hip replacement?
In 2024 the average total payment to Prisma Health Oconee Memorial Hospital for an inpatient hip or knee replacement stay was $15,660 (MS-DRG 470, 21 Medicare stays; Medicare's payment plus the patient's deductible and coinsurance), and the Medicare allowed amount averaged $11,979 per outpatient case (APC 5115, 225 cases).
What is Prisma Health Oconee Memorial Hospital's list price for a joint replacement?
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $91,630, 5.9× 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 Prisma Health Oconee Memorial Hospital?
Yes for Medicare facility payments. Blue Ridge Surgery Center, an orthopedic surgery center 8.1 mi away, is paid about $8,192 by Medicare for a knee replacement (CPT 27447), $7,468 less than an inpatient stay at Prisma Health Oconee Memorial Hospital. Not every patient is a surgery-center candidate.
How does Prisma Health Oconee Memorial Hospital compare with other South Carolina hospitals?
Prisma Health Oconee Memorial Hospital's average total payment per Medicare stay is higher than 79% of the 19 South Carolina hospitals that report inpatient hip or knee replacement.
What do commercial insurers pay Prisma Health Oconee Memorial 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 $35,934 across 6 insurers, ranging from $28,145 to $48,773.