CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: USC Arcadia Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $18,931
Cash Discount Price: $10,500
vs. Medicare Baseline: 1.35x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at USC Arcadia Hospital is $18,931. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,500. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.35x the Medicare baseline. Located in 300 W Huntington Dr, Arcadia, CA.

Cash / Self-Pay

$10,500

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,931

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: $10,500 (75%)

Insurance Median: $18,931 (135%)

Cash: $10,500 (75% of Medicare)

Ins. Median: $18,931 (135% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Cigna	$4,795 - $6,144	34%
UnitedHealthcare	$5,411 - $18,931	39%
Blue Cross Blue Shield	$6,059 - $18,931	43%
Aetna	$6,890 - $18,931	49%
Blue Shield	$15,968 - $22,044	114%
Healthcare Partners	$18,138	129%
Phcs	$18,637	133%
Caremore	$18,931	135%
Central Health	$18,931	135%
Citizen Choice	$18,931	135%
Easy Choice	$18,931	135%
Healthnet	$18,931 - $29,242	135%
Humana	$18,931	135%
Intervalley	$18,931	135%
Kaiser	$18,931	135%
La Care	$18,931	135%
Molina	$18,931 - $19,862	135%
Non Contracted	$18,931	135%
Regal Medical Group	$18,931 - $26,385	135%
Scan	$18,931	135%
Health Sharing Ministry	$21,088	150%
Mhsc Employee Insurance	$26,385	188%
Hst Technology	$28,249	201%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $10,500.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm USC Arcadia Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 470.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.