# Hip or knee replacement (hospital stay): what Highmark Blue Cross Blue Shield pays, by state

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

- Insurer: Highmark Blue Cross Blue Shield (Pennsylvania, Delaware, West Virginia, New York)
- Billing code: 470 (Hospital stays (inpatient))
- Price shown: negotiated in-network price, hospital stay, facility fee
- Prices as of: 2026-09-21
- 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 | 2 | $42,281.57 | $108,101.04 | $173,920.51 | $239,739.97 | $305,559.44 | $16,993.78 | 10x Medicare |
| Pennsylvania | 34 | $10,145.74 | $24,301.44 | $31,064.84 | $37,483.94 | $75,526.49 | $15,447.14 | 2.0x Medicare |
| West Virginia | 4 | $19,751.00 | $31,929.55 | $40,038.09 | $81,302.67 | $192,949.32 | $15,365.07 | 2.6x 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/highmark/statemap_470_US.html  
About this insurer's data, and its other procedures: [index.md](index.md)