What one knee surgery might cost you—$12,000 or $100,000?
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You might assume that once you choose a hospital and check your insurance coverage, you’ve done everything right before a surgery.
But for many Americans, especially retirees, the real surprise comes later—when the bill arrives.
One person might pay $12,870 for a knee replacement, while another is charged over $100,000 for the exact same procedure.
These massive cost differences aren’t always about quality or location.
So what’s really going on—and how can you protect yourself?
A recent report by health care analytics firm Trilliant Health looked at claims from nearly 2,700 hospitals and 3,500 surgery centers.
The results were staggering: a total knee replacement could cost as little as $12,870—or as much as $101,527.
Even within the same state or city, prices varied by three to nine times.
It wasn’t just knees, either—ankle replacements ranged from $22,000 in Austin to nearly $200,000 in New Jersey.
For decades, the real costs of medical care have been hard to find.
Hospitals keep their prices secret, and even insurance companies don’t always share what they’ve negotiated.
New federal price transparency rules are starting to change that, but experts say it’s still a challenge.
“The fact that we now have information related to price, we can hopefully begin to rein in our spending,” said Allison Oakes, chief research officer at Trilliant Health.
One of the most surprising findings? Hospitals that charge more aren’t necessarily better.
Trilliant’s report looked at some of the country’s top-ranked hospitals and found no connection between higher prices and better patient outcomes.
So if you’re paying more, it might not be for better results—it could just be how that hospital sets its rates.
In 2023, the US spent about $4.9 trillion on health care—nearly $14,600 per person.
Yet Americans still have lower life expectancy than people in many other wealthy countries.
One big reason is hospital pricing.
Most employers don’t know what hospitals charge when they design insurance networks, and for individuals with high deductibles, these prices can lead to huge bills before insurance even begins to cover anything.
Over the past 25 years, the cost of health insurance premiums has risen nearly three times faster than worker pay.
Hospitals are a big part of that.
In one example from Houston, an overnight stay could cost between $17,628 and $57,898—just depending on which hospital you go to, even with the same insurance provider.
And in some cases, the same hospital might charge different amounts based on the type of plan you have.
Thanks to recent federal rules, insurance companies must now disclose the rates they’ve negotiated with hospitals.
This could help both employers and patients make smarter decisions.
In New York, a large labor union has tried to steer its members away from high-cost hospitals—and even asked the Justice Department to look into possible anti-competitive behavior.
Transparency alone won’t fix everything, but it’s a powerful start.
Some insurance plans are experimenting with tiered copayments, where your out-of-pocket cost depends on which hospital you choose.
In Massachusetts, this approach led to an 8% drop in overall spending after three years.
Consumers were more likely to pick lower-cost providers once they realized it would save them money on copays.
It’s one way patients can use price transparency to their advantage.
Navigating medical bills isn’t easy, but there are ways to lower your chances of getting hit with a massive charge:
The US health care system can be frustrating, especially when the same treatment costs wildly different amounts.
But asking questions and doing a bit of comparison shopping can go a long way.
Whether you're planning a procedure or just reviewing your insurance plan, it’s worth taking the time to understand your options.
Read next: This simple trick could save you thousands on your hospital bill—here’s how
Have you ever received a surprisingly high medical bill—or found a way to save on one? What advice would you give others trying to navigate health care costs?
But for many Americans, especially retirees, the real surprise comes later—when the bill arrives.
One person might pay $12,870 for a knee replacement, while another is charged over $100,000 for the exact same procedure.
These massive cost differences aren’t always about quality or location.
So what’s really going on—and how can you protect yourself?
Medical costs can vary drastically across hospitals—even for the exact same procedure. Image Source: Pexels / Anna Shvets.
One knee surgery, wildly different prices
A recent report by health care analytics firm Trilliant Health looked at claims from nearly 2,700 hospitals and 3,500 surgery centers.
The results were staggering: a total knee replacement could cost as little as $12,870—or as much as $101,527.
Even within the same state or city, prices varied by three to nine times.
It wasn’t just knees, either—ankle replacements ranged from $22,000 in Austin to nearly $200,000 in New Jersey.
Also read: Could a simple blood test reveal who’s more likely to experience fast-developing Alzheimer’s?
Hospital prices are still mostly hidden
For decades, the real costs of medical care have been hard to find.
Hospitals keep their prices secret, and even insurance companies don’t always share what they’ve negotiated.
New federal price transparency rules are starting to change that, but experts say it’s still a challenge.
“The fact that we now have information related to price, we can hopefully begin to rein in our spending,” said Allison Oakes, chief research officer at Trilliant Health.
Higher cost doesn’t mean better care
One of the most surprising findings? Hospitals that charge more aren’t necessarily better.
Trilliant’s report looked at some of the country’s top-ranked hospitals and found no connection between higher prices and better patient outcomes.
So if you’re paying more, it might not be for better results—it could just be how that hospital sets its rates.
Also read: Could Medicare be expanding? Here’s what the new "Part E" proposal might mean for you
Why health care in the US is so expensive
In 2023, the US spent about $4.9 trillion on health care—nearly $14,600 per person.
Yet Americans still have lower life expectancy than people in many other wealthy countries.
One big reason is hospital pricing.
Most employers don’t know what hospitals charge when they design insurance networks, and for individuals with high deductibles, these prices can lead to huge bills before insurance even begins to cover anything.
Also read: A healthcare crisis in motion—Sudden shutdowns could leave gaps in critical care
Your insurance doesn’t always protect you
Over the past 25 years, the cost of health insurance premiums has risen nearly three times faster than worker pay.
Hospitals are a big part of that.
In one example from Houston, an overnight stay could cost between $17,628 and $57,898—just depending on which hospital you go to, even with the same insurance provider.
And in some cases, the same hospital might charge different amounts based on the type of plan you have.
Also read: Medical debt might still hurt your credit score—here’s what changed and how to protect yourself
What price transparency could change
Thanks to recent federal rules, insurance companies must now disclose the rates they’ve negotiated with hospitals.
This could help both employers and patients make smarter decisions.
In New York, a large labor union has tried to steer its members away from high-cost hospitals—and even asked the Justice Department to look into possible anti-competitive behavior.
Transparency alone won’t fix everything, but it’s a powerful start.
Also read: Uninsured? Here’s how you could actually pay less for hospital bills in this state
Tiered copays: a promising idea
Some insurance plans are experimenting with tiered copayments, where your out-of-pocket cost depends on which hospital you choose.
In Massachusetts, this approach led to an 8% drop in overall spending after three years.
Consumers were more likely to pick lower-cost providers once they realized it would save them money on copays.
It’s one way patients can use price transparency to their advantage.
Also read: Could changes to Medicaid funding put your local hospital in danger?
Simple ways to avoid a surprise bill
Navigating medical bills isn’t easy, but there are ways to lower your chances of getting hit with a massive charge:
- Ask for an estimate: Hospitals and surgery centers are now required to give you a price estimate if you ask.
- Compare prices: Use online tools like Healthcare Bluebook or Fair Health Consumer to see what others are paying.
- Check your network: Even in-network providers can charge very different prices. Call your insurer for guidance.
- Consider outpatient surgery centers: They often offer lower prices than hospitals for the same procedures.
- Negotiate if needed: Don’t be afraid to ask for a discount or payment plan if your bill seems too high.
- Look for tiered copay plans: These can give you a financial incentive to choose lower-cost care providers.
The US health care system can be frustrating, especially when the same treatment costs wildly different amounts.
But asking questions and doing a bit of comparison shopping can go a long way.
Whether you're planning a procedure or just reviewing your insurance plan, it’s worth taking the time to understand your options.
Read next: This simple trick could save you thousands on your hospital bill—here’s how
Have you ever received a surprisingly high medical bill—or found a way to save on one? What advice would you give others trying to navigate health care costs?
