CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Merit Health Women's Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $16,594
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Merit Health Women's Hospital is $16,594. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.18x the Medicare baseline. Located in 1026 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$16,594

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%)
Insurance Median: $16,594 (118%)
Ins. Median: $16,594 (118% 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.

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
Mississippi Department Of Rehabilitation Services $3,200 23%
First Choice Ppo Plus $3,396 24%
First Choice Mpcn $12,421 88%
Cigna $15,508 110%
Humana $16,269 116%
Medicare (plans) $16,269 116%
Node Shared Health Of Ms Mcr Adv $16,269 116%
Node Vantage Health Mcr Adv $16,269 116%
Node Windsor Mcr Adv $16,269 116%
UnitedHealthcare $16,566 - $26,862 118%
Node Devoted Health Mcr Adv $16,594 118%
Node First Choice American Health Of Ms Mcr Adv $16,594 118%
Node Molina Mcr Adv $16,594 118%
Aetna $16,756 119%
Node First Choice Wellcare Mcr Adv $16,897 120%
Node Va $16,897 120%
Blue Cross Blue Shield $18,071 129%
Node Healthy Mississippi Mcr Adv $18,223 130%
First Choice Preferred $18,676 133%
Node First Choice Seven Corners $19,482 139%
First Choice Lgp $20,525 146%
Molina Exchange $21,055 150%
Advanced Health Systems $21,218 151%
Node Us Dept Of Labor $23,764 169%
Occunet $24,849 177%
Ms Work Comp $26,050 185%
Magnolia Exchange $28,991 206%
Vantage Health $33,132 236%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1026 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals