CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Pikeville Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$16,482
about 1.2× the $14,044 Medicare rate · typically $10,520–$17,721
modeled estimate · not a bill or quote
What this hospital charges insurers
$16,188
About the fair price
about $294 under the fair price · 1.2× Medicare
Medicare pays $14,044 Fair price $16,482 This hospital $16,188

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 $16,188

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 $16,482 (about 1.2× the $14,044 Medicare rate). Pikeville Medical Center charges insurers about $16,188 — about the fair price. Located in Pikeville, KY.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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 $13,479 96%
Blue Cross Blue Shieldmajor $13,214 - $30,300 94%
Aetnamajor $13,214 94%
Humanamajor $13,214 94%
CareSource $19,161 136%
Sentara $13,214 94%
WellCare $13,214 - $18,500 94%
+ 3 smaller / regional plans $13,214 - $26,429

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Facility Profile & Credentials

  • Address: 911 Bypass Road, Pikeville, KY 41501
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals