CMS Price Transparency Data
Hip or knee replacement (inpatient stay)
Facility: Uc San Diego Health Hillcrest - Hillcrest Med Ctr
Billing Code: 470 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 470
- Insurance Median: $20,185
- Cash Discount Price: $54,399
- vs. Medicare Baseline: 1.44x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Uc San Diego Health Hillcrest - Hillcrest Med Ctr is $20,185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54,399. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.44x the Medicare baseline. Located in 200 West Arbor Drive, San Diego, CA.
Cash / Self-Pay
$54,399
Average discount available for prompt cash payment at this facility.
Insurance Median
$20,185
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: $54,399 (387%)
Insurance Median: $20,185 (144%)
Cash: $54,399 (387% of Medicare)
Ins. Median: $20,185 (144% 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 |
|---|---|---|
| Community Care Ipa [1131] | $2,300 - $20,185 | 16% |
| California Health & Wellness Medi-Cal [1122] | $2,600 | 19% |
| Alternate Medi-Cal [2001] | $3,106 | 22% |
| Medi-Cal [1048] | $3,106 | 22% |
| Cmn - Canadian Medical Network [1024] | $3,500 | 25% |
| UnitedHealthcare | $3,800 - $106,587 | 27% |
| First Health [1032] | $6,000 | 43% |
| Alternate Blue Shield [2002] | $8,325 - $19,781 | 59% |
| Blue Shield Transplants [1113] | $8,325 | 59% |
| Blue Shield [1014] | $8,325 - $106,587 | 59% |
| Kaiser [1046] | $8,631 | 61% |
| Brand New Day [1089] | $10,659 - $20,185 | 76% |
| Medicaid / KanCare | $10,659 | 76% |
| Aetna | $12,790 - $106,587 | 91% |
| Blue Cross Blue Shield | $12,790 - $106,587 | 91% |
| Cigna | $12,790 - $106,587 | 91% |
| Humana | $12,790 - $90,599 | 91% |
| Mc Blue Shield Generic Payor [164016] | $12,790 | 91% |
| Mc Blue Shield Hmo [164015] | $12,790 | 91% |
| Mc Brand New Day Generic Payor [164031] | $12,790 | 91% |
| Mc Brand New Day Hmo [164030] | $12,790 | 91% |
| Mc Healthnet Generic Payor [164010] | $12,790 | 91% |
| Mc Healthnet Hmo [164004] | $12,790 | 91% |
| Mc Hnet Blue&Gold Aco [164017] | $12,790 | 91% |
| Mc Scan Generic Payor [164034] | $12,790 | 91% |
| Mc Scan Hmo [164035] | $12,790 | 91% |
| Uc Aff Blue Shield Sr/Sdsm [164037] | $12,790 | 91% |
| Padres Workers Compensation [2013] | $17,160 | 122% |
| Padres [2014] | $17,160 | 122% |
| Health Net [1039] | $18,168 - $106,587 | 129% |
| Alternate Scan Health [2088] | $19,176 | 137% |
| Scan Health [1072] | $19,176 | 137% |
| Tricare | $19,833 | 141% |
| Fresenius [1034] | $20,136 | 143% |
| Inland Empire Health Plan [1121] | $20,136 - $20,185 | 143% |
| Molina [1055] | $20,136 - $20,185 | 143% |
| Advantra Freedom [1002] | $20,185 | 144% |
| Affiliated Doctors Of Orange County [2041] | $20,185 | 144% |
| Alignment Health Plan [2020] | $20,185 - $24,478 | 144% |
| Alphacare [2062] | $20,185 | 144% |
| Alternate Brand New Day [2079] | $20,185 | 144% |
| Alternate Health Net Bh [2059] | $20,185 - $106,587 | 144% |
| Ama - American Medical Association [1009] | $20,185 | 144% |
| American Specialty Health Plan [2038] | $20,185 | 144% |
| Arch Health Partners [2000] | $20,185 - $69,282 | 144% |
| Astiva Health [2095] | $20,185 | 144% |
| Bankers Life [1011] | $20,185 | 144% |
| Beacon Health Strategy [2039] | $20,185 | 144% |
| Beaver Med Grp [2075] | $20,185 | 144% |
| Caremore [2028] | $20,185 | 144% |
| Central Health Plan [2026] | $20,185 | 144% |
| Chesapeake Life [1021] | $20,185 | 144% |
| Christian Healthcare Ministries [2030] | $20,185 | 144% |
| Clever Care [2061] | $20,185 | 144% |
| Community Eldercare [1027] | $20,185 | 144% |
| Easy Access Care [2077] | $20,185 | 144% |
| Easy Choice [1029] | $20,185 | 144% |
| Empire Phys Med Grp [2072] | $20,185 | 144% |
| Encompass Med Grp [1030] | $20,185 | 144% |
| Golden Physicians Medical Group [2082] | $20,185 | 144% |
| Graybill Med Grp [1037] | $20,185 - $106,587 | 144% |
| Greater Newport Physicians [2096] | $20,185 | 144% |
| Health Care Support [2011] | $20,185 | 144% |
| Healthcare Partners [2073] | $20,185 | 144% |
| Hemet Community Med Grp - Promisecare [1040] | $20,185 | 144% |
| High Desert Medical Group [2053] | $20,185 | 144% |
| Hmsa - Hawaii Medical Service Assoc Mdcr [1041] | $20,185 | 144% |
| Imperial County Med Grp [1044] | $20,185 | 144% |
| Imperial Health Holdings [1132] | $20,185 | 144% |
| Imperial Health Plan [2081] | $20,185 | 144% |
| Inland Empire Health Plan Transplant [1126] | $20,185 - $42,635 | 144% |
| Inland Faculty Medical Group [2063] | $20,185 | 144% |
| Integrated Health Partners [2068] | $20,185 | 144% |
| Inter Valley Health Plan [2024] | $20,185 | 144% |
| Kern Health Systems [2033] | $20,185 | 144% |
| Key Med Grp [2074] | $20,185 | 144% |
| La Care Health Plan [2025] | $20,185 | 144% |
| Lakeside Medical Group [2054] | $20,185 | 144% |
| Medcare Partners [2084] | $20,185 | 144% |
| Medicare (plans) | $20,185 | 144% |
| Menifee Med Grp [2076] | $20,185 | 144% |
| Mercy Physicians Med Grp [1052] | $20,185 - $74,611 | 144% |
| Monarch Healthcare [2006] | $20,185 | 144% |
| Mutual Of Omaha [1059] | $20,185 | 144% |
| Mvp Healthcare [1060] | $20,185 | 144% |
| Palomar Health [1128] | $20,185 | 144% |
| Premier Patient Care Ipa [2069] | $20,185 | 144% |
| Primary Care Associates Of Ca [2067] | $20,185 | 144% |
| Pyramid Life [1068] | $20,185 | 144% |
| Redlands Community Hospital [2005] | $20,185 | 144% |
| River City Medical Group [2066] | $20,185 | 144% |
| Riverside Medical Clinic [2064] | $20,185 | 144% |
| Sdsm [2017] | $20,185 | 144% |
| Sharp Community Med Grp [1078] | $20,185 - $106,587 | 144% |
| Sharp Health Plan [1079] | $20,185 - $106,587 | 144% |
| Sharp Rees Stealy [1080] | $20,185 - $106,587 | 144% |
| Sierra Medical Group [2048] | $20,185 | 144% |
| Simnsa Health Plan [2047] | $20,185 | 144% |
| St Joseph St Jude [2065] | $20,185 | 144% |
| Sterling Option 1 [1083] | $20,185 | 144% |
| Transamerica [1084] | $20,185 | 144% |
| Tri-City Medical Center [1129] | $20,185 | 144% |
| Tri-City [1085] | $20,185 - $69,282 | 144% |
| United American [1087] | $20,185 | 144% |
| Unlisted Commercial Non-Contracted [1026] | $20,185 | 144% |
| Unlisted Hospice [1035] | $20,185 | 144% |
| Us Marshal Services [1090] | $20,185 | 144% |
| Usaa [1091] | $20,185 | 144% |
| Vantage [1092] | $20,185 - $63,952 | 144% |
| Village Health [1094] | $20,185 | 144% |
| Well Care [1096] | $20,185 | 144% |
| Ximed [2016] | $20,185 | 144% |
| Trivalley Medical Group [2086] | $22,203 | 158% |
| Community Health Group [1022] | $22,809 | 162% |
| Desert Oasis Health Care [2052] | $24,478 | 174% |
| Heritage Victor Valley Medical Group [2045] | $24,478 | 174% |
| Regal Mg 'Heritage Provider Network' [2019] | $24,478 | 174% |
| San Diego Pace [2046] | $24,478 - $24,692 | 174% |
| Alternate Va - Veterans Administration [1239] | $24,692 | 176% |
| Cal Optima [1016] | $24,692 | 176% |
| Champva [1020] | $24,692 | 176% |
| Pace [2044] | $24,692 | 176% |
| State Of California [1082] | $24,692 | 176% |
| Triwest Alternate [2036] | $24,692 | 176% |
| Triwest [2003] | $24,692 | 176% |
| Ucr Prompt Pay Payor [8240] | $24,692 | 176% |
| Va - Veterans Administration [1093] | $24,692 | 176% |
| Multicultural Med Grp [1057] | $38,691 | 275% |
| Scripps Clinic [1073] | $42,635 - $106,587 | 304% |
| Usoc - Us Olympic Committee [1123] | $45,939 | 327% |
| Global Excel [1036] | $53,293 | 379% |
| Sd Physicians Med Grp [1076] | $58,623 - $69,282 | 417% |
| Alternate Sheriff Custody [1106] | $69,282 | 493% |
| Axa Assistance [1098] | $69,282 | 493% |
| Cassidy Med Grp [1019] | $69,282 | 493% |
| Ets - Lifetrac Network [1103] | $69,282 | 493% |
| Health Net Bh (Mhn) [1038] | $69,282 | 493% |
| Health Net Bh (Mhn) [2010] | $69,282 | 493% |
| Interlink Health Services Transplant [1124] | $69,282 | 493% |
| Interlink Health Transplant [2085] | $69,282 | 493% |
| Mgm Resorts [1053] | $69,282 | 493% |
| National Healthcare Solutions Inc [1100] | $69,282 | 493% |
| Quality Health [1069] | $69,282 | 493% |
| Scripps Coastal Med Grp [1074] | $69,282 | 493% |
| Embassy Sponsored [1101] | $72,479 - $74,611 | 516% |
| Interplan [1045] | $74,611 | 531% |
| Pacific Foundation [1063] | $74,611 | 531% |
| Beech Street [1012] | $79,940 | 569% |
| Admar [1001] | $82,072 | 584% |
| Bps - Benefit Plan Services [1015] | $82,072 | 584% |
| Multiplan [1058] | $82,072 | 584% |
| Private Healthcare Systems [1067] | $82,072 - $106,587 | 584% |
| Carnival Cruises [1018] | $85,270 | 607% |
| Alternate Healthnet [1007] | $106,587 | 759% |
| Alternate Kaiser Rad Onc [2089] | $106,587 | 759% |
| Healthnet Transplants [1114] | $106,587 | 759% |
| Olympus Managed Healthcare Inc [1102] | $106,587 | 759% |
| Scripps Health Plan Services [1075] | $106,587 | 759% |
| Sharp Healthcare Transplant [1119] | $143,892 | 1025% |