Hip or knee replacement (inpatient stay)
Facility: Watsonville Community Hospital
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $21,810
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.55x 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 |
|---|---|---|
| California Childrens Srvs | $4,420 - $5,525 | 31% |
| Ccs/Monterey County | $4,420 - $5,525 | 31% |
| Healthy Families | $4,420 - $48,417 | 31% |
| Medi-Cal E.R. | $4,420 - $5,525 | 31% |
| Medi-Cal/Eds | $4,420 - $5,525 | 31% |
| Medicaid / KanCare | $4,420 - $5,525 | 31% |
| Well Path | $4,420 - $5,525 | 31% |
| Alliance/Sccho | $6,630 - $8,288 | 47% |
| Ace-Usa | $21,810 | 155% |
| Alignment Health Plan | $21,810 | 155% |
| Beta Healthcare Group | $21,810 | 155% |
| Blue Shield Ppo | $21,810 - $48,417 | 155% |
| Crawford & Co | $21,810 | 155% |
| Fireman'S Fund Work Comp | $21,810 | 155% |
| Fleming & Associates | $21,810 | 155% |
| Gallagher Bassett Svcs | $21,810 | 155% |
| Hartford Workers' Comp | $21,810 | 155% |
| Health Net Of California | $21,810 | 155% |
| Keenan & Assoc Work Comp | $21,810 | 155% |
| Kemper Group Workers Comp | $21,810 | 155% |
| Liberty Mutual Work Comp | $21,810 | 155% |
| Medicare (plans) | $21,810 | 155% |
| Miscellaneous Work Comp | $21,810 | 155% |
| Pinnacle Healthcare Uc | $21,810 | 155% |
| Republic Idemnity W/Comp | $21,810 | 155% |
| Secure Horizons | $21,810 | 155% |
| Secure Horizons Dign Hmo | $21,810 | 155% |
| Travelers Insurance | $21,810 | 155% |
| Tricare | $21,810 | 155% |
| U.S. Dept. Of Labor | $21,810 | 155% |
| UnitedHealthcare | $21,810 | 155% |
| Veterans Administration | $21,810 | 155% |
| Western Growers Work Comp | $21,810 | 155% |
| Workers Comp | $21,810 | 155% |
| Pinnacle Claims Tpa/Bc | $28,184 | 201% |
| Western Growers Trust/Bc | $28,184 | 201% |
| Nx Health Network | $45,800 | 326% |
| Kaiser Northern | $46,891 | 334% |
| Bs Employee | $48,417 | 345% |
| Ufcw/Valley Clerks | $48,417 | 345% |
| United Agriculture | $48,417 | 345% |