CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Lewisgale Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$18,308

about 1.3× the $14,044 Medicare rate · typically $16,159–$21,322

modeled estimate · not a bill or quote

What this hospital charges insurers

$18,479

About the fair price

about $171 over the fair price · 1.3× Medicare

Medicare pays $14,044 Fair price $18,308 This hospital $18,479

How we calculate the fair BaseRate →

How this hospital compares to other VA hospitals

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

Cheapest $8,878 Priciest $18,479

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

A fair price for a Hip or knee replacement (inpatient stay) is about $18,308 (about 1.3× the $14,044 Medicare rate). Lewisgale Medical Center charges insurers about $18,479 — about the fair price. Located in Salem, VA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$6,108 - $51,003	43%
Blue Cross Blue Shieldmajor	$3,604 - $38,941	26%
Aetnamajor	$17,004 - $32,331	121%
Cignamajor	$16,981 - $41,460	121%
Humanamajor	$16,648	119%
Devoted Health	$16,981	121%
Sentara	$16,648 - $32,729	119%
+ 8 smaller / regional plans	$16,648 - $28,741

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 470.

Insurance Before you use insurance

Call your insurance company to confirm Lewisgale Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 470.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

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

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Lewisgale Medical Center

Compare: Hip or knee replacement (inpatient stay) at other VA hospitals

Carilion Stonewall Jackson Hospital · Lexington $8,878
Childrens Hospital of the Kings Daughters Inc · Norfolk $11,164
Sentara Rmh Medical Center · Harrisonburg $14,457
Sovah Health Danville · Danville $14,523
Clinch Valley Medical Center · Richlands $14,645
Lewisgale Hospital Alleghany · Low Moor $14,889
Sentara Halifax Regional Hospital · South Boston $14,993
Lewisgale Hospital Pulaski · Pulaski $15,116

Insurance negotiated median for the same procedure, sorted lowest first.