Hip or knee replacement (inpatient stay)
Facility: Glendale Adventist Medical Center
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $27,580
- Cash Discount Price: $21,439
- vs. Medicare Baseline: 1.96x 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 |
|---|---|---|
| Blue Shield Mcr Adv | $10,682 | 76% |
| Tricare | $10,682 | 76% |
| Phcs- All Plans | $11,250 | 80% |
| UnitedHealthcare | $15,756 - $43,525 | 112% |
| Medi-Cal | $17,821 | 127% |
| Molina Mcal | $17,821 | 127% |
| Heritage Mcal | $18,856 | 134% |
| Heritage Sr | $19,694 | 140% |
| Alignment Hp Mcr Adv - All Plans | $20,605 | 147% |
| Clever Care Mcr Adv - All Plans | $20,605 | 147% |
| Healthnet Mcr Adv | $20,605 | 147% |
| Molina Mcr | $20,605 | 147% |
| Regal Med Group Mcal | $20,605 | 147% |
| Scan Mcr Adv - All Plans | $20,605 | 147% |
| Healthnet Mcal | $21,168 | 151% |
| Blue Cross Blue Shield | $21,430 - $32,808 | 153% |
| Bc Medi-Cal | $22,434 | 160% |
| Blue Shield Medi-Cal | $23,299 | 166% |
| Heritage Commercial - All Other Plans | $24,235 | 173% |
| Regal Medical Group Commercial - All Other Plans | $24,727 | 176% |
| Dept Of State Hsp Metropolitan- All Plans | $26,787 | 191% |
| Molina Exchange - All Other Plans | $27,817 | 198% |
| Employers Health Network - All Plans | $31,463 | 224% |
| Healthcare Partners- All Plans | $31,499 | 224% |
| Blue Shield Epn - All Other Plans | $35,619 | 254% |
| Caremore Mcr Adv - All Plans | $36,752 | 262% |
| Ah Employee Health Plan - All Plans | $38,750 | 276% |
| La Care Mcr Adv- All Plans | $39,659 | 282% |
| Choicecare - All Plans | $40,118 | 286% |
| Blue Shield Non Epn | $41,008 | 292% |
| Healthnet - All Other Plans | $45,333 | 323% |
| Centivo - All Plans | $46,362 | 330% |
| Cigna | $50,267 | 358% |
| Aetna | $62,960 | 448% |
| First Health- All Plans | $82,897 | 590% |
| Western Growers/Pinnacle - All Plans | $90,984 | 648% |
| Beech Street - All Plans | $92,902 | 661% |
| Corvel- All Plans | $114,341 | 814% |
| Health Mgmt Network - All Plans | $121,487 | 865% |
| Three Rivers - All Plans | $121,487 | 865% |
| Kaiser - All Plans | $122,297 | 871% |