Hip or knee replacement (inpatient stay)
Facility: Adventist Health Bakersfield
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $25,285
- Cash Discount Price: $20,404
- vs. Medicare Baseline: 1.80x 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 | $9,946 | 71% |
| Fhcn Pace Mcr Adv - All Plans | $9,946 | 71% |
| Kaiser Mcr Adv Ip/Op Only | $9,946 | 71% |
| Phcs- All Plans | $10,050 | 72% |
| Amrcn Indian Hlth Proj Mcr Adv - All Plans | $11,935 | 85% |
| Interplan- All Plans | $13,976 | 100% |
| UnitedHealthcare | $15,532 - $20,826 | 111% |
| Kaiser Comm Hmo Ip/Op Only-All Other Plans | $17,107 | 122% |
| Healthnet Mcr Adv | $19,185 | 137% |
| Universal Health Plan Mcare-All Other Plans | $19,185 | 137% |
| Gem Care- All Plans | $19,234 | 137% |
| Blue Shield Epn | $19,953 | 142% |
| Kern Legacy Share Select | $21,872 | 156% |
| Blue Shield Epo/Ppo | $22,169 | 158% |
| Blue Shield Hmo/Pos - All Other Plans | $22,169 | 158% |
| County Of Kern - All Plans | $22,832 | 163% |
| Kern Legacy Hp Epo - All Other Plans | $22,832 | 163% |
| Network Provdrs Llc Mcare -All Payers | $24,940 | 178% |
| Healthnet Hmo/Pos/Ppo/Epo - All Other Plans | $25,285 | 180% |
| Kaiser Mcal Ip/Op Only | $26,579 | 189% |
| Medi-Cal | $26,579 | 189% |
| Oscar - All Plans | $30,696 | 219% |
| Blue Cross Blue Shield | $31,260 - $42,242 | 223% |
| Bc Medi-Cal | $31,367 | 223% |
| Healthnet Mcal | $31,653 | 225% |
| Employee Health Plan - All Plans | $34,533 | 246% |
| Kern Health Systems Mcal | $36,414 | 259% |
| Cigna | $39,969 - $42,643 | 285% |
| Centivo - All Plans | $43,166 | 307% |
| Western Growers/Pinnacle- All Plans | $44,365 | 316% |
| Aetna | $49,411 | 352% |
| First Health/Coventry- All Plans | $81,615 | 581% |
| Beech Street- All Plans | $95,218 | 678% |
| Affiliated Health Funds-All Plans | $108,820 | 775% |
| Integrated Health Plan-All Plans | $108,820 | 775% |
| Three Rivers Provider Network- All Plans | $108,820 | 775% |
| Galaxy Health Network- All Plans | $115,621 | 823% |