Prices for Knee, Hip Replacement Surgeries Vary Across Calif., U.S.

Prices for hip and knee replacement surgeries can vary by tens of thousands of dollars within California and other states, according to a report released Wednesday by the BlueCross BlueShield Association, the Washington Post's "Wonkblog" reports.

For the report, researchers examined three years' worth of BCBS insurers' claims data for more than 53,000 hip and knee procedures in 64 different markets (Millman, "Wonkblog," Washington Post, 1/21).

National Price Variations

Nationwide, the average price for knee and hip replacements -- two of the fastest-growing medical procedures in the U.S. -- was just more than $30,000. However, the costs varied greatly within the same markets, which researchers described as a "seemingly random" pattern (Morgan, Reuters, 1/21).

For example, while the average price for a knee replacement surgery was $31,124, the study found that the price of the operation in Dallas ranged from $16,772 to $61,585 -- a 267% price variation.

Meanwhile, the average price for hip replacement was $30,124 ("Wonkblog," Washington Post, 1/21). However, the price in Massachusetts ranged between $17,910 and $73,987 -- a 313% price variation (Reuters, 1/21).

Prices also varied greatly across markets, according to "Wonkblog." For example, the average price of a hip replacement procedure in Montgomery, Ala., was $16,399, while it cost as much as $55,412 in Fort Collins, Colo.

According to "Wonkblog," the gap in prices can be attributed to several factors, including:

• A hospital's mix of privately and publicly insured patients;
• Competition within markets;
• Location; and
• How much no-cost care a hospital provides ("Wonkblog," Washington Post, 1/21).

Variations Within California

The study examined knee and hip replacement surgery costs in five markets within California.

Prices for knee replacement surgery ranged from:

• $18,179 to $36,388 in Orange County;
• $19,581 to $19,724 in Fresno;
• $20,868 to $33,924 in Los Angeles-Long Beach;
• $22,795 to $28,222 in Riverside-San Bernardino; and
• $37,662 to $43,133 in San Diego.

Meanwhile, prices for hip replacement surgery ranged from:

• $17,260 to $46,447 in Los Angeles-Long Beach;
• $18,531 to $19,970 in Fresno;
• $19,214 to $23,718 in Riverside-San Bernardino;
• $19,607 to $28,657 in Orange County; and
• $23,696 to $47,386 in San Diego.

Of all the markets examined in the report, San Diego had the fifth-highest average cost for knee replacement surgery, at $41,042. Fresno had the third-lowest average cost for the same surgery, at $19,653.

Meanwhile, Fresno and Riverside-San Bernardino had the third- and fourth-lowest average cost for hip replacement surgery, at $19,250 and $21,381, respectively (BCBS report, 1/21).