CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Camc Greenbrier Valley Medical Center, Inc

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $15,524
  • Cash Discount Price: $76,502
  • vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Camc Greenbrier Valley Medical Center, Inc is $15,524. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76,502. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.11x the Medicare baseline. Located in 1320 Maplewood Avenue, Ronceverte, WV.
Cash / Self-Pay
$76,502

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,524

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%)
Cash / Self-Pay: $76,502 (545%)
Insurance Median: $15,524 (111%)
Cash: $76,502 (545% of Medicare)
Ins. Median: $15,524 (111% 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 $14,650 - $70,772 104%
Humana $14,650 - $68,852 104%
Sentra Health $14,650 - $26,776 104%
The Health Plan $14,650 - $68,852 104%
UnitedHealthcare $14,650 - $61,202 104%
Unicare $14,785 - $15,524 105%
Clear Spring Health $15,090 107%
Aetna $15,383 - $74,972 110%
Ally Align $15,383 110%
Caresource $15,524 - $61,202 111%
Integrated Medical Solutions $27,836 198%
Naphcare $29,301 209%
Greenbrier Resort $45,901 327%
Healthsmart $45,901 327%
Multiplan $61,967 - $66,557 441%
Fedmed $68,852 490%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 Maplewood Avenue, Ronceverte, WV 24970
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals