Hip or knee replacement (inpatient stay)
Facility: AHMC Anaheim Regional Medical Center
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $20,360
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.45x 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 |
|---|---|---|
| Private Healthcare Systems | $1,489 | 11% |
| Care First | $1,500 - $20,360 | 11% |
| Health Net Inc | $1,503 - $46,915 | 11% |
| Healthnet Cal Optima Medi-Cal/Healthy Families | $1,503 | 11% |
| Caloptima | $1,750 - $20,360 | 12% |
| First Health | $1,840 - $33,465 | 13% |
| Ahmc Reciprocity Agreement | $1,937 - $6,556 | 14% |
| Choicecare | $1,975 | 14% |
| Memorial Healthcare Ipa/Cap/Valuation Rates | $2,391 | 17% |
| Private Pay Flat Rate | $2,500 | 18% |
| One Legacy | $3,000 | 21% |
| Medical Acquisition Company | $4,000 | 28% |
| Alta Los Angeles Hospital | $4,307 | 31% |
| Prospect Health Plan | $4,307 - $28,000 | 31% |
| Ahmc Health Self-Insurance Epo | $4,365 | 31% |
| Blue Cross Blue Shield | $5,706 - $20,360 | 41% |
| Blue Shield Of California | $5,835 - $20,360 | 42% |
| Cigna | $7,370 - $34,500 | 52% |
| Veterans Administration | $14,518 | 103% |
| Monarch Health Plan | $19,342 - $20,360 | 138% |
| Humana | $19,953 | 142% |
| Aetna | $20,360 - $27,626 | 145% |
| Aids Health Foundation | $20,360 | 145% |
| Alignment Health Plan | $20,360 | 145% |
| Altamed Health Network | $20,360 | 145% |
| Apa Aco Inc | $20,360 | 145% |
| Avanti | $20,360 - $24,889 | 145% |
| Beverly Hospital | $20,360 - $22,815 | 145% |
| Brand New Day | $20,360 - $25,926 | 145% |
| California Health Plan | $20,360 | 145% |
| Central Health Of California | $20,360 | 145% |
| Davita Heatlhcare Partners Plan Inc | $20,360 | 145% |
| Healthcare Partners | $20,360 | 145% |
| Healthnet | $20,360 | 145% |
| Heritage Provider Network | $20,360 - $23,852 | 145% |
| Kaiser Foundation Hospitals | $20,360 | 145% |
| Medicare (plans) | $20,360 - $21,582 | 145% |
| Pacificare | $20,360 | 145% |
| Scan Health Plan | $20,360 | 145% |
| Seoul Medical Group | $20,360 - $20,741 | 145% |
| Wellcare | $20,360 | 145% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $20,741 | 148% |
| Emanate Health | $20,741 - $25,926 | 148% |
| Innovative Integrated Health (Iih)/Orange County Pace | $20,741 | 148% |
| Self-Pay | $20,741 | 148% |
| Nchp | $21,379 | 152% |
| Align Senior Care | $21,582 | 154% |
| Knox-Keene Act | $25,926 | 185% |
| Angels Baseball Workers Comp | $29,325 | 209% |
| Orange County Preferred Provider Organization | $33,465 | 238% |
| Athens Administrators | $34,500 | 246% |
| Capp Care | $34,500 | 246% |
| Marriot Intl | $34,500 | 246% |
| Non Contracted Workers Comp | $34,500 | 246% |