# Hip or knee replacement (hospital stay): what CareFirst BlueCross BlueShield pays, by state

The whole hospital stay for a hip or knee joint replacement, without major complications - the most common inpatient surgery.

- Insurer: CareFirst BlueCross BlueShield
- Billing code: 470 (Hospital stays (inpatient))
- Price shown: negotiated in-network price, hospital stay, doctor's fee
- Prices as of: unknown
- All of the insurer's plans pooled; the map also shows single networks

| State | Providers | Lowest | 25th pct | Median | 75th pct | Highest | Medicare pays | Median vs Medicare |
|---|---|---|---|---|---|---|---|---|
| Delaware | 1 | $32,037.10 | $32,037.10 | $32,037.10 | $32,037.10 | $32,037.10 | $16,993.78 | 1.9x Medicare |
| District of Columbia | 14 | $27,106.83 | $29,753.28 | $31,867.36 | $35,071.26 | $53,557.84 | $19,491.88 | 1.6x Medicare |
| Maryland | 1 | $35,572.77 | $35,572.77 | $35,572.77 | $35,572.77 | $35,572.77 | $25,078.72 | 1.4x Medicare |
| Virginia | 19 | $22,514.12 | $27,410.64 | $32,488.46 | $32,488.46 | $34,862.94 | $15,613.28 | 2.1x Medicare |

**“x Medicare”** compares each price with what original Medicare actually paid hospitals in the same state for the same kind of stay in 2024, the newest year it has published: the average per stay, the patient’s share included, at hospitals with more than ten such stays. Medicare’s payment varies by hospital (wages, teaching, low-income patients), so this is a state average, not any one hospital’s rate. Insurers write their contracts as a share of Medicare, so 1.3x means the insurer pays 30% more than Medicare would; Medicare Advantage plans generally pay close to 1.0x.

Prices are what the insurer has agreed to pay, not what you will be billed. This is a statewide summary: prices vary far more between towns and between practices than these medians suggest, and "providers" counts everyone with a contracted price, not only those who perform the procedure.

Map: https://medicalpricetransparency.netlify.app/insurers/carefirst/statemap_470_US.html  
About this insurer's data, and its other procedures: [index.md](index.md)