Knee Replacement Cost in Peoria, IL – 2025 Complete Guide
Facing the possibility of knee replacement surgery can be overwhelming—especially when you’re unsure about the cost. The cost of knee replacement in Peoria, IL can vary widely, and understanding what to expect financially is just as important as understanding the medical procedure itself. This 2025 guide is based on data from trusted sources like the American Academy of Orthopaedic Surgeons, CMS.gov, and Healthcare Bluebook, helping you make informed decisions in your healthcare journey.
What is the average cost of knee replacement in Peoria, IL?
The average cost of a total knee replacement in Peoria, IL ranges from $30,000 to $55,000, depending on the facility and the complexity of the case. According to Healthcare Bluebook, a fair price for knee replacement surgery in the Peoria area is approximately $36,000. This estimate includes hospital fees, surgeon fees, anesthesia, and post-operative care.
The Centers for Medicare & Medicaid Services (CMS.gov) reports that Medicare patients typically pay less out-of-pocket, with average total costs around $25,000, of which Medicare covers a substantial portion. However, private insurance and out-of-pocket payments may result in higher or lower totals depending on your plan and provider network.
It’s important to note that outpatient knee replacement procedures, which are becoming more common, may be less expensive than inpatient surgeries. Always request a detailed quote from your provider to understand the full scope of costs.
What factors affect the cost of knee replacement?
Several variables influence the total cost of knee replacement surgery in Peoria, IL. These include the type of procedure (partial vs. total replacement), the surgical setting (inpatient hospital vs. outpatient surgery center), and the surgeon’s experience. According to the American Academy of Orthopaedic Surgeons (AAOS), more complex cases or those requiring specialized implants may incur higher costs.
Other cost factors include pre-operative imaging, physical therapy, anesthesia, and post-surgical rehabilitation. The facility’s location and whether it is in-network with your insurance provider also play a significant role. The American Hospital Association notes that regional pricing differences and negotiated insurance rates can result in significant cost variation even within the same city.
Additionally, patient-specific factors such as underlying health conditions, the need for assistive devices, and extended hospital stays can increase the total cost of care. Always ask for an itemized estimate and discuss your insurance benefits with your provider before scheduling surgery.
Does insurance cover knee replacement?
Yes, most insurance plans—including Medicare, Medicaid, and private insurance—typically cover medically necessary knee replacement surgery. According to CMS.gov, Medicare Part B covers 80% of the approved cost after the deductible is met, while Medicare Advantage plans may offer additional benefits or lower out-of-pocket costs.
Private insurance coverage varies by provider and plan. The National Association of Insurance Commissioners (NAIC) recommends reviewing your policy or contacting your insurer to confirm coverage details, including deductibles, copays, and network requirements. Some plans may require prior authorization or documentation of failed conservative treatments, such as physical therapy or injections, before approving surgery.
Medicaid coverage is state-specific. In Illinois, Medicaid typically covers knee replacement surgery when deemed medically necessary, but you may need to use approved providers. Always verify coverage with your insurance carrier and surgeon’s office to avoid unexpected expenses.
Are there payment plans or financing options available in Peoria?
Yes, many healthcare providers and hospitals in Peoria offer payment plans or financing options to help manage the cost of knee replacement surgery. According to the Healthcare Financial Management Association (HFMA), most hospitals provide interest-free or low-interest payment plans for patients who qualify.
Additionally, third-party financing options like CareCredit or medical loans through local credit unions may be available. These programs often allow patients to spread payments over 6 to 60 months, depending on credit approval and loan terms.
Some orthopedic practices in Peoria also offer income-based discounts or financial assistance programs. OSF HealthCare and UnityPoint Health, two major providers in the region, have financial counselors who can help patients navigate payment options. Be sure to ask your provider about available resources during your consultation.
How does the cost in Peoria compare to other Illinois cities?
The cost of knee replacement in Peoria is generally lower than in larger metropolitan areas like Chicago or Springfield. According to FairHealth.org, the average cost of a total knee replacement in Chicago can range from $40,000 to $70,000, while Springfield averages between $35,000 and $60,000.
Peoria’s healthcare market benefits from a lower cost of living and competitive hospital pricing. Healthcare Bluebook lists Peoria as having a “fair price” zone for knee replacement, making it a more affordable option for residents and even patients from nearby cities seeking cost-effective care.
However, pricing can still vary between providers within Peoria. It’s essential to compare quotes from multiple orthopedic centers and verify what’s included in the estimate to make an informed decision.
What’s included in the knee replacement cost?
The total cost of knee replacement surgery typically includes several components: pre-operative evaluations, the surgical procedure itself, anesthesia, hospital or surgical center fees, and post-operative care. According to the American Academy of Orthopaedic Surgeons (AAOS), these bundled services are often grouped into a single estimate but may be billed separately depending on the provider.
In Peoria, a comprehensive knee replacement package may also include physical therapy sessions, follow-up visits, and any necessary medical equipment such as walkers or braces. Some providers offer bundled pricing models that cover all aspects of care for a fixed fee, which can simplify billing and reduce unexpected costs.
It’s important to ask for a breakdown of what’s included in your quote. For example, some estimates may not include imaging (like MRIs or X-rays), lab work, or extended rehab services. Clarifying these details upfront can help you avoid surprise bills later.
Do I need a partial or total knee replacement, and how much does it cost?
Whether you need a partial or total knee replacement depends on the extent of joint damage. A partial knee replacement, also known as unicompartmental knee arthroplasty, is typically recommended when only one part of the knee is affected. According to the Mayo Clinic, partial replacements involve less bone removal and may result in quicker recovery.
Cost-wise, partial knee replacements are generally less expensive. Healthcare Bluebook estimates the fair price in Peoria for a partial knee replacement at around $28,000, compared to $36,000 for a total knee replacement. However, not all patients are candidates for partial procedures, and long-term outcomes may differ.
Your orthopedic surgeon will determine the best option based on imaging, physical exams, and your symptom history. Be sure to discuss both the clinical and financial implications of each procedure during your consultation.
How long does the knee replacement process take?
The entire knee replacement process—from initial consultation to full recovery—can take several months. According to the American Association of Hip and Knee Surgeons (AAHKS), pre-operative preparation, including imaging and medical clearance, typically takes 2–4 weeks.
The surgery itself usually lasts 1–2 hours, followed by a hospital stay of 1–3 days for inpatient procedures. Outpatient knee replacements, which are increasingly common, may allow you to return home the same day. Post-operative physical therapy generally begins within days and continues for 6–12 weeks.
Most patients are able to resume normal daily activities within 6–8 weeks, though full recovery—including regaining strength and flexibility—can take up to 6 months. Your recovery timeline may vary based on age, overall health, and the type of procedure performed.
What is the success rate of knee replacement?
Knee replacement surgery is considered one of the most successful orthopedic procedures. According to the American Academy of Orthopaedic Surgeons (AAOS), more than 90% of total knee replacements are still functioning well 15 years after surgery.
Success rates are influenced by factors such as the surgeon’s experience, the type of implant used, and patient adherence to rehabilitation protocols. A study published in The Journal of Bone and Joint Surgery found that patient satisfaction rates exceed 85%, particularly when pain relief and mobility are the primary goals.
In Peoria, major orthopedic centers like OSF Saint Francis Medical Center and UnityPoint Health have board-certified specialists with high volumes of successful knee replacements. Choosing an experienced surgeon and following post-op care instructions are key to achieving the best outcome.
Are there affordable alternatives to knee replacement?
Yes, there are several non-surgical and minimally invasive alternatives to knee replacement that may be appropriate depending on the severity of your condition. These include physical therapy, corticosteroid injections, hyaluronic acid injections, and platelet-rich plasma (PRP) therapy.
According to the American College of Rheumatology, these treatments can relieve pain and improve function, especially in the early stages of osteoarthritis. Costs vary: physical therapy sessions may range from $100 to $200 each, while injections can cost between $500