Hip or knee replacement (inpatient stay)
Facility: Encino Hospital Medical Center
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $21,080
- Cash Discount Price: $18,491
- vs. Medicare Baseline: 1.50x 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 |
|---|---|---|
| Alignment | $18,491 | 132% |
| Blue Shield Of Ca, Va | $18,491 | 132% |
| Blue Shield Of Promise | $18,491 | 132% |
| Health Net Of Ca | $18,491 - $33,506 | 132% |
| La Care Health Plan | $18,491 | 132% |
| Managed Health Network | $18,491 | 132% |
| Medicare (plans) | $18,491 | 132% |
| Molina | $18,491 | 132% |
| Renal Payer Solutions | $18,491 | 132% |
| Tricare | $18,491 - $25,889 | 132% |
| Usa Senior Care Network | $18,491 | 132% |
| Brand New Day | $18,676 - $22,915 | 133% |
| Aids Healthcare Foundation | $18,861 | 134% |
| Imperial Health Plan Ca | $19,601 | 140% |
| Corvel | $21,080 | 150% |
| Zelis Healthcare | $21,080 | 150% |
| Americas Choice Provider Network | $21,524 | 153% |
| Multiplan | $21,524 | 153% |
| Prime Health Services, Inc. | $21,524 | 153% |
| Three Rivers | $21,524 | 153% |
| Healthsmart Preferred Care Network | $21,746 | 155% |
| Provider Select | $21,968 | 156% |
| Provider Network Of America | $22,190 | 158% |
| Employer Direct Healthcare | $24,039 | 171% |
| Aetna | $26,901 | 192% |
| Workers Comp | $27,732 | 197% |
| National Healthcare Solutions, Inc (Nhsi) | $29,586 | 211% |