CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Bluegrass Community Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $2,124
Cash Discount Price: $8,038
vs. Medicare Baseline: 0.15x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Bluegrass Community Hospital is $2,124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,038. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 0.15x the Medicare baseline. Located in 360 Amsden Avenue, Versailles, KY.

Cash / Self-Pay

$8,038

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,124

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: $8,038 (57%)

Insurance Median: $2,124 (15%)

Cash: $8,038 (57% of Medicare)

Ins. Median: $2,124 (15% 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.

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
Blue Cross Blue Shield	$2,124 - $23,005	15%
Ccn	$2,124	15%
Essence	$2,124	15%
Medicare (plans)	$2,124	15%
Passport	$2,124	15%
Secure Horizons	$2,124	15%
Todays Options	$2,124	15%
Tricare	$2,124	15%
Unicare	$2,124	15%
Wellcare	$2,124	15%
Humana	$2,145 - $2,210	15%
UnitedHealthcare	$2,166 - $3,196	15%
Aetna	$2,187	16%

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 $8,038.
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 Bluegrass Community Hospital 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.