CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Uh Cleveland Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $26,604
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Uh Cleveland Medical Center is $26,604. 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 1.89x the Medicare baseline. Located in 11100 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,604

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: $26,604 (189%)
Ins. Median: $26,604 (189% 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 $20,033 - $36,514 143%
Blue Cross Blue Shield $20,033 - $36,214 143%
Cigna $20,033 - $28,605 143%
Devoted Health $20,033 143%
Humana $20,033 143%
Medical Mutual Of Ohio $20,033 - $38,470 143%
Molina $20,033 143%
Primetime Health Plan $20,033 143%
Summacare $20,033 - $33,302 143%
The Health Plan $20,033 - $32,044 143%
UnitedHealthcare $20,033 - $41,534 143%
Wellcare By Allwell $20,033 143%
Paramount $20,634 147%
Perennial Advantage Of Ohio $21,034 150%
Valor Health Plans $21,034 150%
University Health Employee Plan (Contigo) $22,158 158%
Jp Farley $26,604 189%
Aultcare $30,326 216%
Ambetter / Centene $36,059 257%
Caresource $36,059 257%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11100 Euclid Avenue, Cleveland, OH 44106
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals