CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Memorialcare Long Beach Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $25,733
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.83x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Memorialcare Long Beach Medical Center is $25,733. 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 1.83x the Medicare baseline. Located in 2801 Atlantic Ave, Long Beach, CA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$25,733

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: $25,733 (183%)

Ins. Median: $25,733 (183% 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
Monarch Health Plan	$20,512 - $49,013	146%
Scan Health Plan	$20,944	149%
Aetna	$21,592 - $71,128	154%
Avanti Health System	$21,592	154%
Blue Cross Blue Shield	$21,592 - $59,797	154%
Blue Shield	$21,592 - $43,223	154%
Citizens Choice	$21,592	154%
Global Care Medical Group	$21,592 - $25,910	154%
Healthcare La	$21,592 - $25,910	154%
Healthcare Partners	$21,592 - $53,332	154%
Healthnet	$21,592 - $59,725	154%
Heritage Provider Network	$21,592	154%
Humana	$21,592	154%
La Care	$21,592 - $23,319	154%
Onecare	$21,592	154%
Preferred	$21,592	154%
St. Francis Medical Center	$21,592	154%
UnitedHealthcare	$21,592 - $66,666	154%
Wellcare	$21,592	154%
Molina	$22,240 - $34,979	158%
Alignment Health	$22,671	161%
Clever Care	$22,671	161%
Easy Choice	$22,671	161%
Select Health	$22,671 - $32,388	161%
Universal Care	$22,671	161%
Central Health	$23,751	169%
Cigna	$30,713 - $48,397	219%
Synermed	$32,388	231%
Centivo	$48,582	346%

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 Memorialcare Long Beach Medical Center 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.