WASHINGTON — Hospitals within the same city sometimes charge tens of thousands of dollars more for the same procedures, according to figures the government released for the first time Wednesday. The federal list sheds new light on the mystery of just how high a hospital bill might go — and whether it's cheaper to get the care somewhere else.

There are vast disparities nationally. The average charges for joint replacement range from about $5,300 at an Ada, Okla., hospital to $223,000 in Monterey Park, Calif.

It's not just national or even regional geography. Hospitals within the same city also vary wildly. In Jackson, Miss., average inpatient charges for services that may be provided to treat heart failure range from $9,000 to $51,000, the Department of Health and Human Services said.

Hospitals usually receive less money than they charge, however. Their charges are akin to a car dealership's "list price." Most patients won't be hit with these bills, because they are paid by private insurance, Medicare or Medicaid. The government and insurance companies routinely negotiate lower payments with hospitals.

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