CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: University Hospitals Ahuja Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $21,246
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at University Hospitals Ahuja Medical Center is $21,246. 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 1.51x the Medicare baseline. Located in 3999 Richmond Road, Beachwood, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$21,246

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: $21,246 (151%)
Ins. Median: $21,246 (151% 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 $13,454 - $25,209 96%
Blue Cross Blue Shield $13,454 - $25,096 96%
Cigna $13,454 - $21,246 96%
Devoted Health $13,454 96%
Humana $13,454 96%
Medical Mutual Of Ohio $13,454 - $29,929 96%
Molina $13,454 96%
Primetime Health Plan $13,454 96%
Summacare $13,454 - $24,512 96%
The Health Plan $13,454 - $24,276 96%
UnitedHealthcare $13,454 - $39,441 96%
Wellcare By Allwell $13,454 96%
Paramount $13,857 99%
Perennial Advantage Of Ohio $14,126 101%
Valor Health Plans $14,126 101%
University Health Employee Plan (Contigo) $17,875 127%
Jp Farley $22,519 160%
Aultcare $22,718 162%
Ambetter / Centene $24,216 172%
Caresource $24,216 172%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3999 Richmond Road, Beachwood, OH 44122
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals