CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: East Liverpool City Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $15,683
  • Cash Discount Price: $15,683
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at East Liverpool City Hospital is $15,683. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,683. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.12x the Medicare baseline. Located in 425 West 5Th Street, East Liverpool, OH.
Cash / Self-Pay
$15,683

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,683

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%)
Cash / Self-Pay: $15,683 (112%)
Insurance Median: $15,683 (112%)
Cash: $15,683 (112% of Medicare)
Ins. Median: $15,683 (112% 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
Keenan $7,650 54%
Medicaid / KanCare $13,068 93%
UnitedHealthcare $13,841 - $23,342 99%
Blue Cross Blue Shield $14,123 101%
Buckeye Community Health Plan $14,123 - $25,093 101%
Medical Mutual Of Oh $14,123 101%
Molina $14,123 - $22,741 101%
Ubh $14,123 101%
Care Source $14,547 - $22,741 104%
Health America $14,547 104%
Communicare $15,112 108%
Perennial $15,535 111%
Medicare (plans) $15,683 112%
Devoted Health $16,468 117%
Valor Health Plan $16,781 119%
Three Rivers $18,423 131%
Provider Select $18,803 134%
Naphcare $18,820 134%
Multiplan (Fka Private Healthcare Systems) $18,993 135%
Worker Compensation $18,993 135%
Employer Direct Healthcare $20,388 145%
Tricare $21,208 151%
National Healthcare Solutions (Nhsi) $25,093 179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 425 West 5Th Street, East Liverpool, OH 43920
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals