Hip or knee replacement (inpatient stay)
Facility: Menifee Global Medical Center
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $19,379
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.38x 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 |
|---|---|---|
| Sr Capitation | $2,200 | 16% |
| Primecare Commercial | $3,010 | 21% |
| Altamed Health Services Senior | $3,548 | 25% |
| Altamed Sr/Pace | $3,548 | 25% |
| Hpn Commercial/Covered Ca | $3,641 | 26% |
| UnitedHealthcare | $4,223 - $19,379 | 30% |
| Cigna | $6,500 | 46% |
| Humana | $17,915 | 128% |
| Molina Covered Ca | $18,222 | 130% |
| Aetna | $19,379 - $23,251 | 138% |
| Blue Shield Senior | $19,379 | 138% |
| Central Health Plan Senior | $19,379 | 138% |
| Clever Care Health Plan Sr | $19,379 | 138% |
| For Your Benefit Senior | $19,379 | 138% |
| Guidant Health Plan Senior | $19,379 | 138% |
| Health Net Senior | $19,379 | 138% |
| Hpn Senior | $19,379 | 138% |
| Imperial Health Plan Of Ca | $19,379 | 138% |
| Kaiser Senior | $19,379 | 138% |
| Managed Health Network Sr | $19,379 | 138% |
| Medicare (plans) | $19,379 | 138% |
| Neighborhood Healthcare Pace | $19,379 | 138% |
| Point Comfort Underwriters | $19,379 | 138% |
| Primecare Senior | $19,379 | 138% |
| Prospect Health Plan Sr Hmo | $19,379 | 138% |
| Scan Senior | $19,379 | 138% |
| Self Pay/Ab774/Charity Discount | $19,379 | 138% |
| Veterans Administration | $19,379 | 138% |
| Ic | $21,427 | 153% |
| Align Senior Care | $21,705 | 155% |
| Welbehealth Sr/Pace | $21,705 | 155% |
| Prime Health Services Senior | $22,286 | 159% |
| Iehp Covered Ca | $24,224 | 172% |
| Blue Shield Epn | $25,968 | 185% |
| Coventry | $26,133 - $27,149 | 186% |
| Prospect Health Plan Comm Hmo | $26,162 | 186% |
| Health Net Enhanced Ppo | $27,131 | 193% |
| Ava Hospice | $27,601 | 197% |
| Living Waters Hospice | $27,601 | 197% |
| Pacific Valley Hospice | $27,601 | 197% |
| Silverado Hospice | $27,601 | 197% |
| Tricare | $27,601 | 197% |
| Vna Hospice | $27,601 | 197% |
| Health Net Comm | $30,038 | 214% |
| Prime Health Services Wcomp | $31,992 | 228% |
| Blue Shield Commercial | $32,557 | 232% |
| Three Rivers Network | $33,914 | 241% |
| Velocity | $33,914 | 241% |
| Three Rivers Wcomp | $34,836 | 248% |
| Workers Comp Non-Contracted | $35,547 | 253% |