Background: Few studies to date have investigated healthcare administrators’ knowledge of implant costs, and, to the authors’ knowledge, none have evaluated surgeons’ knowledge of implant costs comparing their own cases to a general cohort. The purpose of this study was to analyze cost perceptions surrounding orthopaedic implants across subspecialties within a cohort of musculoskeletal surgeons and healthcare administrators. Methods: A 10-question survey, consisting of 10 fracture patients with their associated postoperative radiographs and the corresponding implant list, was distributed to administrators and musculoskeletal surgeons at a single Level I trauma hospital. Surgeons and administrators were asked to estimate the total cost of each of the constructs given on the survey. The estimates were subtracted from the actual implant costs, with average cost differences assessed as a net value for cohorts, surgeon specialties, and question type. Results: Administrators averaged an overestimation of $4655.22/case and surgeons averaged an overestimation of $41.61/case. The surgeon cohort averaged an underestimation of $608.06/case for their subspecialty cases and an underestimation of $3160.07/case for the control cases, neurosurgeons excluded. Traumatologists averaged an underestimation of $381.24/case overall, an underestimation of $379.72/case for their subspecialty cases, and an underestimation of $13.06/case for control cases. Conclusions: This study identified that neither surgeons nor administrators could accurately estimate implant costs. Orthopaedic surgeons appeared more accurate and may be uniquely positioned to interface with administrators. Although our study was limited by a small sample size, it pointed to opportunity for collaboration between surgeons and administrators to better understand implant costs and maximize value.