CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Steele Memorial Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $40,348
Cash Discount Price: $32,193
vs. Medicare Baseline: 2.87x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Steele Memorial Medical Center is $40,348. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32,193. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 2.87x the Medicare baseline. Located in 203 South Daisy Street, Salmon, ID.

Cash / Self-Pay

$32,193

Average discount available for prompt cash payment at this facility.

Insurance Median

$40,348

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$14,044.15

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,044.15 (100%)

Cash / Self-Pay: $32,193 (229%)

Insurance Median: $40,348 (287%)

Cash: $32,193 (229% of Medicare)

Ins. Median: $40,348 (287% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $14,044.15 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 287% of the Medicare baseline (a markup of 187%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$2,732 - $40,777	19%
Pacific Source Mcr Adv	$5,279	38%
Windsor Hp Mcr Adv - All Plans	$5,279	38%
Select Health Mcr Adv	$5,332	38%
Blue Cross Blue Shield	$5,385 - $42,924	38%
Liberty Healthshare - All Plans	$8,446	60%
Pacific Source - All Other Plans	$38,631	275%
Cigna	$39,576	282%
Mountain Health Co-Op - All Plans	$40,777	290%
Regence Blue Shield - All Plans	$40,777	290%
Select Health Inc - All Other Plans	$40,777	290%
UnitedHealthcare	$40,777	290%
Multiplan - All Plans	$42,065	300%
Three Rivers - All Plans	$42,065	300%
Ichn, Llc - All Plans	$42,924	306%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $32,193.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Steele Memorial Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 470.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.