Hip or knee replacement (inpatient stay)
Facility: Banner Gateway Medical Center
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $18,851
- Cash Discount Price: $27,749
- vs. Medicare Baseline: 1.34x 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.
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 |
|---|---|---|
| Aetna | $17,536 - $50,169 | 125% |
| Arizona Physicians Ipa | $17,536 | 125% |
| Banner Health | $17,536 | 125% |
| Banner University Health Plan | $17,536 | 125% |
| Blue Cross Blue Shield | $17,536 - $61,842 | 125% |
| Care 1St | $17,536 | 125% |
| Cigna | $17,536 - $57,065 | 125% |
| Gila River Health Care Corporation | $17,536 | 125% |
| Health Choice Arizona, Inc. | $17,536 - $26,304 | 125% |
| Health Net | $17,536 - $25,954 | 125% |
| Humana | $17,536 - $18,062 | 125% |
| Kaiser Foundation Health Plan | $17,536 | 125% |
| Mercy Care | $17,536 | 125% |
| Triwest Healthcare Alliance Corp - Va Ccn | $17,536 | 125% |
| UnitedHealthcare | $17,536 - $50,000 | 125% |
| Upmc Health Plan | $17,536 | 125% |
| Wellpoint (Fka Amerigroup) | $17,536 | 125% |
| Carekin | $18,413 | 131% |
| Devoted Health Services | $18,413 | 131% |
| Arizona Priority Care | $19,290 | 137% |
| Gold Kidney Health Plan | $19,290 | 137% |
| Oscar Health Plan | $28,935 | 206% |