CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Conway Regional Medical Center, Inc

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $12,550
Cash Discount Price: $9,189
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Conway Regional Medical Center, Inc is $12,550. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,189. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 0.89x the Medicare baseline. Located in 2302 College Avenue, Conway, AR.

Cash / Self-Pay

$9,189

Average discount available for prompt cash payment at this facility.

Insurance Median

$12,550

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: $9,189 (65%)

Insurance Median: $12,550 (89%)

Cash: $9,189 (65% of Medicare)

Ins. Median: $12,550 (89% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Health Link	$1,958	14%
Occunet	$9,428	67%
Allwell	$12,236	87%
Blue Cross Blue Shield	$12,236 - $16,149	87%
Medipak	$12,236	87%
UnitedHealthcare	$12,236 - $17,571	87%
Usable	$12,236	87%
Wellmark	$12,358	88%
Humana	$12,364	88%
Aetna	$12,603	90%
Cigna	$12,603 - $17,763	90%
Coresource	$15,084	107%
Assured Benefits	$16,027	114%
Non Contracted	$16,149	115%
Ambetter / Centene	$16,550	118%
Qualchoice	$17,690	126%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $9,189.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Conway Regional Medical Center, Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 470.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.