CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Saint Joseph Mount Sterling

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$15,530

about 1.1× the $14,044 Medicare rate · typically $15,210–$15,626

modeled estimate · not a bill or quote

What this hospital charges insurers

$15,610

About the fair price

about $80 over the fair price · 1.1× Medicare

Medicare pays $14,044 Fair price $15,530 This hospital $15,610

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 $15,610

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 $15,530 (about 1.1× the $14,044 Medicare rate). Saint Joseph Mount Sterling charges insurers about $15,610 — about the fair price. Located in Mount Sterling, 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	$14,903 - $19,300	106%
Blue Cross Blue Shieldmajor	$15,341 - $20,495	109%
Aetnamajor	$13,150 - $15,841	94%
Humanamajor	$14,611 - $18,516	104%
CareSource	$30,759	219%
Molina	$14,903 - $16,149	106%
WellCare	$14,903 - $15,380	106%

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 Saint Joseph Mount Sterling 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 Saint Joseph Mount Sterling

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.