Hip or knee replacement (inpatient stay)
Facility: Kingman Regional Medical Center
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $37,433
- Cash Discount Price: $44,536
- vs. Medicare Baseline: 2.67x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 267% of the Medicare baseline (a markup of 167%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Humana | $9,371 - $87,163 | 67% |
| Health Choice Generations | $16,139 | 115% |
| Hpn Sierra Nevada Mcr Adv | $16,139 | 115% |
| Medicare (plans) | $16,139 | 115% |
| Triwest - All Plans | $16,139 | 115% |
| UnitedHealthcare | $16,623 - $58,660 | 118% |
| Care 1St Mcr Adv-All Other Plans | $16,946 | 121% |
| Mercy Care Adv Snp-All Other Plans | $17,753 | 126% |
| Apipa - Ahcccs-All Other Plans | $20,868 | 149% |
| Health Choice Az | $20,868 | 149% |
| Care 1St Mcaid | $21,912 | 156% |
| Mercy Care Ahcccs Ddd | $22,955 | 163% |
| Geo Group Chc Az State Prison-All Plans | $24,209 | 172% |
| Blue Cross Blue Shield | $34,518 | 246% |
| Health Choice- All Other Plans | $40,348 | 287% |
| Health Plan Of Nevada-All Other Plans | $76,729 | 546% |
| Aetna | $77,365 | 551% |
| Health Choice Hie Exchange | $101,796 | 725% |
| Multiplan-All Plans | $101,796 | 725% |
| Cigna | $114,521 | 815% |
| Three Rivers-All Plans | $117,066 | 834% |
| America'S Choice Provider Network-All Plans | $120,883 | 861% |
| Az Foundation-All Plans | $127,245 | 906% |
| Mediversal-All Plans | $127,245 | 906% |
| One Health Plan-All Plans | $127,245 | 906% |
| Universal Health-All Plans | $127,245 | 906% |