CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Mercy Hospital Lincoln

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$16,406

about 1.2× the $14,044 Medicare rate · typically $11,405–$23,833

modeled estimate · not a bill or quote

What this hospital charges insurers

$11,352

Below the fair price — a good deal

about $5,054 under the fair price · 0.8× Medicare

Medicare pays $14,044 Fair price $16,406 This hospital $11,352 Cash price $29,519 Hospital's list price $45,414

How we calculate the fair BaseRate →

How this hospital compares to other MO hospitals

One of the lower prices — 7 of 8 other MO hospitals charge more for the same procedure.

Cheapest $9,158 Priciest $14,911

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

A fair price for a Hip or knee replacement (inpatient stay) is about $16,406 (about 1.2× the $14,044 Medicare rate). Mercy Hospital Lincoln charges insurers about $11,352, or about $29,519 in cash — below the fair price — a good deal. Located in Troy, MO.

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	$2,550 - $20,813	18%
Blue Cross Blue Shieldmajor	$2,550 - $11,352	18%
Aetnamajor	$2,473	18%
Cignamajor	$3,020	22%
Humanamajor	$2,550	18%
Ambetter (Centene)	$5,480	39%
HealthLink	$3,019 - $3,321	21%
+ 20 smaller / regional plans	$2,550 - $5,480

Government programs also on file: Medicare, Medicaid.

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 (about 29,519), 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 Mercy Hospital Lincoln 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 Mercy Hospital Lincoln

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

The Children's Mercy Hospital · Kansas City $9,158
Mercy Hospital Perry · Perryville $11,596
Mercy Hospital Carthage · Carthage $12,006
Mosaic Life Care at St Joseph · Saint Joseph $12,038
Long Term Acute Care Hospital Mosaic Life Care at St Joseph · Saint Joseph $12,038
St Mary's Medical Center · Blue Springs $14,076
St Joseph Medical Center · Kansas City $14,346
Mercy Hospital Jefferson · Crystal City $14,911

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