CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Henrico Doctors' Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $15,114
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Henrico Doctors' Hospital is $15,114. 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 1.08x the Medicare baseline. Located in 1602 Skipwith Road, Richmond, VA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,114

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: $15,114 (108%)
Ins. Median: $15,114 (108% 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
Blue Cross Blue Shield $3,080 - $41,054 22%
United $3,601 - $38,063 26%
Aetna $13,270 - $39,773 94%
Humana $14,603 104%
Sentara Health $14,603 104%
United Behavioral Health $14,603 104%
UnitedHealthcare $14,603 104%
Cigna $14,895 - $42,876 106%
Devoted $14,895 106%
Virginia Premier Health $14,895 106%
Bright Health $14,920 - $20,264 106%
Align Senior Care $15,041 107%
Clear Spring Health Plan $15,041 107%
Davita Village Health $15,187 108%
Lifeworks $15,333 109%
Pyramid Life $16,063 114%
Universal Healthcare Group $16,063 114%
Oscar $22,294 159%
Optima Health $32,729 233%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1602 Skipwith Road, Richmond, VA 23229
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals