CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Banner Boswell Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 470
  • Insurance Median: $15,211
  • Cash Discount Price: $19,634
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Banner Boswell Medical Center is $15,211. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,634. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.08x the Medicare baseline. Located in 13632 N 99Th Ave, Sun City, AZ.
Cash / Self-Pay
$19,634

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,211

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: $19,634 (140%)
Insurance Median: $15,211 (108%)
Cash: $19,634 (140% of Medicare)
Ins. Median: $15,211 (108% 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
Aetna $14,487 - $47,780 103%
Arizona Physicians Ipa $14,487 103%
Banner Health $14,487 103%
Banner University Health Plan $14,487 103%
Blue Cross Blue Shield $14,487 - $61,689 103%
Care 1St $14,487 103%
Cigna $14,487 - $57,065 103%
Gila River Health Care Corporation $14,487 103%
Health Choice Arizona, Inc. $14,487 - $21,730 103%
Health Net $14,487 - $21,441 103%
Humana $14,487 - $14,922 103%
Kaiser Foundation Health Plan $14,487 103%
Mercy Care $14,487 103%
Triwest Healthcare Alliance Corp - Va Ccn $14,487 103%
UnitedHealthcare $14,487 - $50,000 103%
Upmc Health Plan $14,487 103%
Wellpoint $14,487 103%
Carelon $15,211 108%
Devoted Health Services $15,211 108%
Arizona Priority Care $15,936 113%
Gold Kidney Health Plan $15,936 113%
Oscar Health Plan $23,903 170%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13632 N 99Th Ave, Sun City, AZ 85351
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals