Hip or knee replacement (inpatient stay)
Facility: Paradise Valley Hospital
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $19,637
- Cash Discount Price: $19,637
- vs. Medicare Baseline: 1.40x 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 |
|---|---|---|
| Blue Shield Of Ca, Va | $19,637 | 140% |
| Ca Foundation For Medical Care | $19,637 | 140% |
| Central Health | $19,637 | 140% |
| Choice Physicians Network | $19,637 | 140% |
| Clever Care Of Golden State, Inc | $19,637 | 140% |
| Community Health Group | $19,637 | 140% |
| Health Excel Ins | $19,637 | 140% |
| Health Net Of Ca | $19,637 - $35,583 | 140% |
| Heritage Provider Netwrok | $19,637 - $25,528 | 140% |
| Managed Health Network | $19,637 | 140% |
| Medicare (plans) | $19,637 | 140% |
| Molina | $19,637 | 140% |
| Renal Payer Solutions | $19,637 | 140% |
| Tricare | $19,637 - $26,052 | 140% |
| UnitedHealthcare | $19,637 | 140% |
| Usa Senior Care Network | $19,637 | 140% |
| Verda Health Plan | $19,637 | 140% |
| Brand New Day | $19,834 | 141% |
| Imperial Health Plan Of Ca | $20,816 | 148% |
| Health Net Federal Service (Cdcr) | $24,547 | 175% |
| Employer Direct Healthcare | $25,528 | 182% |
| Integrated Medical Solutions | $25,528 | 182% |
| Ca Dept Of Correction & Rehab | $27,492 | 196% |
| Naphcare | $30,438 - $39,275 | 217% |
| National Healthcare Solutions, Inc (Nhsi) | $31,420 | 224% |
| Scripps Health | $33,383 | 238% |
| Aetna | $33,613 | 239% |
| Worker Comp | $34,653 | 247% |