CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Rutherford Regional Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$17,659

about 1.3× the $14,044 Medicare rate · typically $13,313–$21,891

modeled estimate · not a bill or quote

What this hospital charges insurers

$14,262

Below the fair price — a good deal

about $3,397 under the fair price · 1.0× Medicare

Medicare pays $14,044 Fair price $17,659 This hospital $14,262 Cash price $23,483 Hospital's list price $58,707

How we calculate the fair BaseRate →

How this hospital compares to other NC hospitals

A typical price — 3 charge more and 5 charge less, among the 9 NC hospitals compared.

Cheapest $12,504 Priciest $15,494

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

A fair price for a Hip or knee replacement (inpatient stay) is about $17,659 (about 1.3× the $14,044 Medicare rate). Rutherford Regional Medical Center charges insurers about $14,262, or about $23,483 in cash — below the fair price — a good deal. Located in Rutherfordton, NC.

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	$13,930 - $17,942	99%
Blue Cross Blue Shieldmajor	$14,262 - $15,810	102%
Aetnamajor	$14,262	102%
Humanamajor	$14,405 - $21,308	103%
AmeriHealth	$15,999	114%
CareSource	$31,458	224%
Devoted Health	$14,401	103%
Health Net	$14,262	102%
+ 3 smaller / regional plans	$14,262

Government programs also on file: Medicare, Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 23,483), 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 Rutherford Regional Medical Center 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 Rutherford Regional Medical Center

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

Maria Parham Medical Center · Henderson $12,504
Haywood Regional Medical Center · Clyde $12,776
Frye Regional Medical Center · Hickory $13,055
Sentara Albemarle Medical Center · Elizabeth City $13,600
Wilson Medical Center · Wilson $13,765
Harris Regional Hospital · Sylva $14,371
Carteret General Hospital · Morehead City $15,195
Central Carolina Hospital · Sanford $15,494

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