CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Huntington Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $26,944
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.92x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Huntington Hospital is $26,944. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.92x the Medicare baseline. Located in 100 W California Blvd, Pasadena, CA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$26,944

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%)

Insurance Median: $26,944 (192%)

Ins. Median: $26,944 (192% 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
Aetna	$18,908 - $34,181	135%
Avanti Hospitals, Llc	$18,908	135%
California Physiciansæ Service, Dba Blue Shield Of California	$18,908 - $30,782	135%
Dignity Health	$18,908	135%
Heritage Provider Network	$18,908 - $26,471	135%
Humana	$18,908	135%
Inter Valley Health Plan	$18,908	135%
Kaiser Foundation Hospitals On Behalf Of Its Southern California Region	$18,908 - $51,997	135%
Pacific Pace, Llc And Pasadena Hospital Association, Ltd	$18,908	135%
Prospect Health Plan, Inc.	$18,908 - $31,198	135%
UnitedHealthcare	$18,908 - $27,217	135%
Universal Care, Inc. D/B/A Brand New Day	$18,908 - $28,362	135%
Health Net Of California, Inc.	$20,704 - $47,648	147%
Blue Cross Blue Shield	$22,847 - $31,182	163%
L.A. Care Health Plan	$24,581	175%
Providence St. Joseph Health Network	$34,980	249%

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 $X.
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 Huntington 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.