# Hip or knee replacement (hospital stay): what EmblemHealth pays, by state

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

- Insurer: EmblemHealth
- Billing code: 470 (Hospital stays (inpatient))
- Price shown: negotiated in-network price, hospital stay, facility fee
- Prices as of: 2026-08-01
- 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 |
|---|---|---|---|---|---|---|---|---|
| Connecticut | 5 | $27,155.00 | $27,155.00 | $27,155.00 | $27,155.00 | $65,416.00 | $19,326.37 | 1.4x Medicare |
| Maine | 1 | $27,155.00 | $27,155.00 | $27,155.00 | $27,155.00 | $27,155.00 | $18,052.03 | 1.5x Medicare |
| New Jersey | 2 | $65,416.00 | $65,416.00 | $65,416.00 | $65,416.00 | $65,416.00 | $17,454.77 | 3.8x Medicare |
| New York | 228 | $7,472.56 | $40,875.57 | $55,932.31 | $72,279.74 | $183,517.47 | $23,235.14 | 2.4x Medicare |
| Pennsylvania | 19 | $31,485.00 | $31,485.00 | $31,485.00 | $31,485.00 | $31,485.00 | $15,447.14 | 2.0x Medicare |
| Wisconsin | 1 | $27,155.00 | $27,155.00 | $27,155.00 | $27,155.00 | $27,155.00 | $14,936.04 | 1.8x 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/emblem/statemap_470_US.html  
About this insurer's data, and its other procedures: [index.md](index.md)