CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Upper Valley Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence
A fair price for this
$24,500
about 1.7× the $14,044 Medicare rate · typically $16,545–$38,972
modeled estimate · not a bill or quote
What this hospital charges insurers
$37,906
Above the fair price
about $13,406 over the fair price · 2.7× Medicare
Medicare pays $14,044 Fair price $24,500 This hospital $37,906

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

Highest price of the 9 OH hospitals we have prices for — worth calling around.

Cheapest $8,680 Priciest $37,906

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

A fair price for a Hip or knee replacement (inpatient stay) is about $24,500 (about 1.7× the $14,044 Medicare rate). Upper Valley Medical Center charges insurers about $37,906 — above the fair price. Located in Troy, OH.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $24,500. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield AetnaCignaHumanaKaiser 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 $42,141 300%
Blue Cross Blue Shieldmajor $22,890 - $33,671 163%
Medical Mutual $59,214 422%
+ 1 smaller / regional plan $14,360 - $21,539
Government programs also on file: Medicare.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 3130 N Dixie Highway, Troy, OH 45373
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals