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Procedure Pricing Comparison

Hip or knee replacement (inpatient stay) Cost

Location: Roanoke, VA Metro Area

MS-DRG Code: 470 (MS-DRG)

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
1.00×vs. Fair Market Price
Position vs. 1.00× Fair PriceRight at U.S. Average (0%) 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Compares typical commercial prices against the fair price benchmark after accounting for local wages and case complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Value Leader
CMS Star RatingNot RatedOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety ScoreNot ScoredComposite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Factual Overview

A Hip or knee replacement (inpatient stay) in the Roanoke, VA Metro Area area ranges from $16,884 to $36,747 across 2 facilities — a 2.2× swing for the exact same procedure, so where you go matters. Each facility below links to its own page, where its price is checked against the fair BaseRate. Start with the cheapest and compare.

Hospital Comparison Table (Ordered by Price)

Hospital Details Cash Price Actions
Lewisgale Medical Center
★ No CMS Rating | |
Unavailable Cost
Carilion Medical Center
★ No CMS Rating | |
$36,747 Cost
Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 36.3%

Audit a Bill or Quote at Lewisgale Medical Center (Zero PHI Required)

MS-DRG 470
Fair BaseRate™ $16,884
Medicare Rate $9,793
Self-Pay Cash $16,884
Insurer Median $36,747
Pre-filled with Lewisgale Medical Center’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $32,014 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $32,014

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $32,014).

Step 2 · Cash vs. Insurance Arbitrage Save $71,309 Paying Cash

Self-Pay Cash Rate ($16,884) Beats Your Bill

Lewisgale Medical Center's published 45 CFR § 180 self-pay cash rate is $16,884 (vs. $36,747 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$71,309 Above Fair BaseRate

Negotiate Toward $16,884 Fair BaseRate ($9,793 Medicare)

Your bill ($88,193) is $71,309 above the denoised Fair BaseRate ($16,884) and 9.0× the $9,793 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, MS-DRG code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.