CMS Price Transparency Data
Hip or knee replacement (inpatient stay)
Facility: Adventist Health White Memorial
Billing Code: 470 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 470
- Insurance Median: $24,784
- Cash Discount Price: $22,751
- vs. Medicare Baseline: 1.76x Medicare
The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Adventist Health White Memorial is $24,784. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22,751. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.76x the Medicare baseline. Located in 1720 Cesar E Chavez Avenue, Los Angeles, CA.
Cash / Self-Pay
$22,751
Average discount available for prompt cash payment at this facility.
Insurance Median
$24,784
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: $22,751 (162%)
Insurance Median: $24,784 (176%)
Cash: $22,751 (162% of Medicare)
Ins. Median: $24,784 (176% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Kindred Ip Only-All Plans | $4,350 | 31% |
| Preferred Ipa La Care Mcal Cap | $4,850 | 35% |
| Care First Medi-Cal | $5,000 | 36% |
| UnitedHealthcare | $11,332 - $50,957 | 81% |
| Blue Shield Medi-Cal | $17,900 | 127% |
| Access Group | $19,015 | 135% |
| Ahp - All Other Plans | $19,015 | 135% |
| Lasalle Mg Commercial - All Other Plans | $19,015 | 135% |
| Altamed Medi-Cal - All Other Plans | $20,521 | 146% |
| Bright Health - All Plans | $20,736 | 148% |
| Blue Shield Mcr Adv | $21,923 | 156% |
| Access Senior - All Other Plans | $22,371 | 159% |
| Ahp Senior | $22,371 | 159% |
| Altamed Connect | $22,371 | 159% |
| Brand New Day Mcare - All Plans | $22,371 | 159% |
| Bs Va Mcare | $22,371 | 159% |
| Care First Mcare - All Other Plans | $22,371 | 159% |
| Healthnet Mcr Adv | $22,371 | 159% |
| Humana | $22,371 | 159% |
| Lasalle Mg Senior | $22,371 | 159% |
| Medicare (plans) | $22,371 | 159% |
| Molina Mcare | $22,371 | 159% |
| Preferred Senior | $22,371 | 159% |
| Scan Health Mcare - All Plans | $22,371 | 159% |
| Sunlight Living Hlth Mcr Adv-All Other Plans | $22,371 | 159% |
| Tricare | $22,371 | 159% |
| Clever Care - All Plans | $22,571 | 161% |
| Healthcare Inc - All Other Plans | $22,776 | 162% |
| Pacific Alliance Mcare - All Other Plans | $22,818 | 162% |
| Intergrated Medical - All Plans | $22,908 | 163% |
| Blue Cross Blue Shield | $23,265 - $33,958 | 166% |
| Access Medi-Cal | $23,396 | 167% |
| Ahp Medi-Cal | $23,396 | 167% |
| Lasalle Mg Medi-Cal | $23,396 | 167% |
| Medi-Cal | $23,396 | 167% |
| Molina Medi-Cal | $23,396 | 167% |
| Pacific Ipa Medi-Cal | $23,396 | 167% |
| Preferred Medi-Cal | $23,396 | 167% |
| Alta Los Angeles Mcr 1/1/19-All Other Plans | $24,098 | 172% |
| Blue Shield Epn | $26,149 | 186% |
| Assoc Hispanic Physcns Hmo/Mcr Adv-All Other Plans | $26,845 | 191% |
| Preferred Commercial - All Other Plans | $26,845 | 191% |
| Healthnet Mcal | $27,864 | 198% |
| Bc Medi-Cal | $28,159 | 201% |
| Healthcare Inc Medi-Cal | $28,669 | 204% |
| Avanti Mcal | $28,886 | 206% |
| Preferred Healthy | $29,245 | 208% |
| Alta Los Angeles Mcal 1/1/19 | $29,734 | 212% |
| Blue Shield - All Other Plans | $29,952 | 213% |
| Caremore Mcare - All Plans | $29,953 | 213% |
| Molina Benefit Exchange - All Other Plans | $30,200 | 215% |
| Php-Prospect Health Plan Cap - All Plans | $32,437 | 231% |
| Assoc Hispanic Physcns Mcal | $32,754 | 233% |
| Healthnet Comm Care | $33,567 | 239% |
| Avanti Mcr Adv - All Other Plans | $33,813 | 241% |
| Pacific Alliance Medi-Cal | $35,160 | 250% |
| Healthnet - All Other Plans | $35,501 | 253% |
| Hcpamg - All Plans | $38,492 | 274% |
| Aetna | $38,772 | 276% |
| Ah Employee Health Plan - All Plans | $40,267 | 287% |
| Cigna | $41,736 - $44,557 | 297% |
| Pacific Ipa - All Other Plans | $43,758 | 312% |
| Centivo - All Plans | $50,334 | 358% |
| Kaiser- All Plans | $51,822 | 369% |
| La Care Mcr Adv - All Plans | $60,255 | 429% |
| Western Growers/Pinnacle - All Plans | $71,384 | 508% |
| First Heatlh Ppo - All Plans | $73,310 | 522% |
| Phcs Ppo - All Plans | $82,157 | 585% |
| Beech Street - All Plans | $84,685 | 603% |
| Interplan Ppo - All Plans | $91,353 | 650% |
| Ahf - All Plans | $94,797 | 675% |
| Corvel Corp - All Plans | $101,117 | 720% |
| Multiplan Ppo - All Plans | $104,909 | 747% |
| Healthmannet - All Plans | $107,437 | 765% |
| Next Inc Ppo - All Plans | $107,437 | 765% |
| Trpn - All Plans | $107,437 | 765% |
| Fpn Ppo - All Plans | $113,756 | 810% |