Expand chart
Data: Centers for Medicare & Medicaid Services; Chart: Chris Canipe/Axios

More than nine out of 10 hospitals charge at least $30,000 for joint replacement surgery one of the most common inpatient procedures — and one out of six hospitals charges $90,000 or more, according to an Axios analysis of 2016 federal health care data.

The bottom line: Hospitals set prices for any test or procedure at whatever level they want, often well above what Medicare pays. While those prices often aren't what patients pay, they still help dictate what society at large pays for health care.

The background: Large variation in hospital pricing has been understood for several years. The concept gained more awareness in 2013, when Steven Brill published a TIME article about hospital charges that eventually led to the federal government releasing data on hospital and physician payments.

New studies have shown how market concentration factors into pricing.

  • Hospitals have argued that charges are misleading because private and public health insurers don't pay those amounts, which is true.
  • But they still matter a lot. List prices often are starting points, with no relation to cost, that are used in negotiations with private insurers. They also are the baseline for uninsured patients and people who have to deal with out-of-network bills — like this week's infamous case of a teacher in Texas.

How we did this analysis: We combed through and combined spreadsheets of hospital charges and Medicare payments, which the Centers for Medicare & Medicaid Services posts annually.

What we found: For joint replacements, like hip and knee surgeries, prices are still all over the map. However, Medicare pays less than $13,000 on average for a joint replacement.

  • For-profit companies own (or used to own in 2016) nine out of the 10 hospitals with the highest list prices for joint replacement surgeries.
  • Memorial Hospital of Salem County, a small hospital in New Jersey owned by the publicly traded Community Health Systems, had the highest joint replacement price in the country in 2016 at $267,726. CHS submitted a statement but did not explain the rationale for its charges.
  • HCA Healthcare, another for-profit hospital chain, owns two facilities that each charged more than $200,000 for joint replacements in 2016. The company submitted a statement but did not explain the rationale for its charges.
  • Many well-known not-for-profit hospital systems, like Cedars-Sinai in Los Angeles, also rank among the highest-charging hospitals for joint replacements.

That's not all: Aside from the wide distribution in what hospitals charge for joint replacements, many hospitals also heavily increased prices from 2015 to 2016.

  • St. Francis Medical Center in New Jersey raised prices for joint replacement surgeries the most of any hospital in the country in 2016 — a 77% hike to more than $135,000. The hospital did not respond to questions.
  • More than 400 hospitals raised joint replacement prices by at least 10% in 2016.
Expand chart
Data: Centers for Medicare & Medicaid Services; Chart: Chris Canipe/Axios

Go deeper

Updated 13 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 9 a.m. ET: 31,647,930 — Total deaths: 971,711 Total recoveries: 21,776,599Map.
  2. U.S.: Total confirmed cases as of 9 a.m. ET: 6,897,661 — Total deaths: 200,818 — Total recoveries: 2,646,959 — Total tests: 96,612,436Map.
  3. Health: Hospitals want more time to repay pandemic loans — Supply shortages continue to plague testing.
  4. Business: The high-wage jobs aren't coming back
  5. Vaccines: Johnson & Johnson begins large phase 3 trial — The FDA plans to toughen standards.
  6. Sports: Less travel is causing the NBA to see better basketball.
Kendall Baker, author of Sports
57 mins ago - Sports

Less travel is causing the NBA to see better basketball

Illustration: Aïda Amer/Axios

In addition to keeping out the coronavirus, the NBA bubble has also delivered a stellar on-court product, with crisp, entertaining play night in and night out.

Why it matters: General managers, athletic trainers and league officials believe the lack of travel is a driving force behind the high quality of play — an observation that could lead to scheduling changes for next season and beyond.

Senate Republicans release report on Biden-Ukraine investigation with rehashed information

Sen. Ron Johnson (R-Wis.). Photo: Tom Williams/CQ-Roll Call, Inc via Getty Images

Senate Republicans, led by Sens. Ron Johnson (R-Wis.) and Chuck Grassley (R-Iowa), on Wednesday released an interim report on their probe into Joe Biden and his son's dealings in Ukraine.

Why it matters: The report's rushed release ahead of the presidential election is certainly timed to damage Biden, amplifying bipartisan concern that the investigation was meant to target the former vice president's electoral chances.

Get Axios AM in your inbox

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Subscription failed
Thank you for subscribing!