CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Banner Goldfield Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $16,456
Cash Discount Price: $16,205
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Banner Goldfield Medical Center is $16,456. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,205. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.17x the Medicare baseline. Located in 2050 West Southern Avenue, Apache Junction, AZ.

Cash / Self-Pay

$16,205

Average discount available for prompt cash payment at this facility.

Insurance Median

$16,456

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: $16,205 (115%)

Insurance Median: $16,456 (117%)

Cash: $16,205 (115% of Medicare)

Ins. Median: $16,456 (117% 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	$15,673 - $47,780	112%
Arizona Physicians Ipa	$15,673	112%
Banner Health	$15,673	112%
Banner University Health Plan	$15,673	112%
Blue Cross Blue Shield	$15,673 - $48,919	112%
Care 1St	$15,673	112%
Cigna	$15,673 - $57,065	112%
Gila River Health Care Corporation	$15,673	112%
Health Choice Arizona, Inc.	$15,673 - $23,509	112%
Health Net	$15,673 - $23,196	112%
Humana	$15,673 - $16,143	112%
Kaiser Foundation Health Plan	$15,673	112%
Mercy Care	$15,673	112%
Triwest Healthcare Alliance Corp - Va Ccn	$15,673	112%
UnitedHealthcare	$15,673 - $50,000	112%
Upmc Health Plan	$15,673	112%
Wellpoint	$15,673	112%
Carelon	$16,456	117%
Devoted Health Services	$16,456	117%
Arizona Priority Care	$17,240	123%
Gold Kidney Health Plan	$17,240	123%
Oscar Health Plan	$23,509	167%

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 $16,205.
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 Goldfield 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.