CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Memorial Mission Hospital and Asheville Surgery Ce

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $24,962
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.78x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Memorial Mission Hospital and Asheville Surgery Ce is $24,962. 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 1.78x the Medicare baseline. Located in 509 Biltmore Ave, Asheville, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$24,962

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: $24,962 (178%)
Ins. Median: $24,962 (178% 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
United $6,223 - $46,923 44%
United Behavioral Health $15,909 113%
Aetna $16,227 - $41,849 116%
Alignment Health $16,227 116%
Humana $16,386 - $16,545 117%
Wellcare $16,386 - $25,711 117%
Cigna $16,545 118%
Provider Partners Health Plan $16,705 119%
Pruitthealth Premier $16,705 119%
Troy Healthcare $16,705 119%
Apex Health $16,864 120%
Longevity Health Plan $17,023 121%
Nhc Advantage $17,023 121%
Amerihealth Caritas $18,136 - $32,855 129%
Healthteam Advantage $19,091 136%
Blue Cross Blue Shield $24,962 - $42,187 178%
Vaya Health $25,711 183%
Amerihealth $25,960 185%
Partners Health Management $26,210 187%
Oscar $32,527 232%
Ambetter / Centene $32,818 234%
Medcost $34,929 249%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 Biltmore Ave, Asheville, NC 28801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals