CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: St Elizabeth Edgewood

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$18,992

about 1.4× the $14,044 Medicare rate · typically $15,375–$24,650

modeled estimate · not a bill or quote

What this hospital charges insurers

$15,841

Below the fair price — a good deal

about $3,151 under the fair price · 1.1× Medicare

Medicare pays $14,044 Fair price $18,992 This hospital $15,841

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

Highest price of the 9 KY hospitals we have prices for — worth calling around.

Cheapest $8,915 Priciest $15,841

Black dot = this hospital, among the 9 KY hospitals with a price for this procedure. Full list below.

A fair price for a Hip or knee replacement (inpatient stay) is about $18,992 (about 1.4× the $14,044 Medicare rate). St Elizabeth Edgewood charges insurers about $15,841 — below the fair price — a good deal. Located in Edgewood, KY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$15,172 - $47,569	108%
Blue Cross Blue Shieldmajor	$13,381 - $49,050	95%
Aetnamajor	$46,386	330%
Cignamajor	$50,375	359%
Humanamajor	$14,874	106%
Ambetter (Centene)	$29,749	212%
CareSource	$14,874 - $29,749	106%
Cigna HealthSpring	$14,874	106%
Devoted Health	$15,618	111%
Molina	$14,874	106%
WellCare	$16,064	114%
+ 2 smaller / regional plans	$14,874 - $36,740

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 470.

Insurance Before you use insurance

Call your insurance company to confirm St Elizabeth Edgewood is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 470.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Elizabeth Edgewood

Compare: Hip or knee replacement (inpatient stay) at other KY hospitals

T J Samson Community Hospital · Glasgow $8,915
Murray-Calloway County Hospital · Murray $12,980
Georgetown Community Hospital · Georgetown $13,126
Bourbon Community Hospital · Paris $13,289
Saint Joseph London · London $13,485
Clark Regional Medical Center · Winchester $13,488
Tristar Greenview Regional Hospital · Bowling Green $13,578
Jackson Purchase Medical Center · Mayfield $13,925

Insurance negotiated median for the same procedure, sorted lowest first.