CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: University Hospitals Samaritan Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $14,646
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at University Hospitals Samaritan Medical Center is $14,646. 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 1.04x the Medicare baseline. Located in 1025 Center St, Ashland, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$14,646

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: $14,646 (104%)
Ins. Median: $14,646 (104% 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
Aetna $14,646 - $26,071 104%
Blue Cross Blue Shield $14,646 104%
Cigna $14,646 104%
Devoted Health $14,646 104%
Humana $14,646 104%
Molina $14,646 104%
Primetime Health Plan $14,646 104%
Summacare $14,646 104%
The Health Plan $14,646 104%
UnitedHealthcare $14,646 104%
Wellcare By Allwell $14,646 104%
Paramount $15,086 107%
Perennial Advantage Of Ohio $15,379 110%
Valor Health Plans $15,379 110%
University Health Employee Plan (Contigo) $17,875 127%
Ambetter / Centene $26,364 188%
Caresource $26,364 188%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1025 Center St, Ashland, OH 44805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals