CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Banner Casa Grande Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $18,750
Cash Discount Price: $21,894
vs. Medicare Baseline: 1.34x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Banner Casa Grande Medical Center is $18,750. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21,894. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.34x the Medicare baseline. Located in 1800 East Florence Boulevard, Casa Grande, AZ.

Cash / Self-Pay

$21,894

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,750

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: $21,894 (156%)

Insurance Median: $18,750 (134%)

Cash: $21,894 (156% of Medicare)

Ins. Median: $18,750 (134% 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
Aetna	$17,046 - $37,450	121%
Arizona Physicians Ipa	$17,046	121%
Banner Health	$17,046	121%
Banner University Health Plan	$17,046	121%
Blue Cross Blue Shield	$17,046 - $40,434	121%
Care 1St	$17,046	121%
Cigna	$17,046 - $40,998	121%
Gila River Health Care Corporation	$17,046	121%
Health Choice Arizona, Inc.	$17,046 - $25,569	121%
Health Net	$17,046 - $25,228	121%
Humana	$17,046 - $18,069	121%
Kaiser Foundation Health Plan	$17,046	121%
Mercy Care	$17,046	121%
Triwest Healthcare Alliance Corp - Va Ccn	$17,046	121%
UnitedHealthcare	$17,046 - $31,835	121%
Upmc Health Plan	$17,046	121%
Wellpoint	$17,046	121%
Carelon	$17,898	127%
Arizona Priority Care	$18,750	134%
Devoted Health Services	$18,750	134%
Gold Kidney Health Plan	$18,750	134%
Oscar Health Plan	$25,569	182%
Naphcare	$27,273	194%

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 $21,894.
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 Banner Casa Grande Medical Center 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.