Hip or knee replacement (inpatient stay)
Facility: Whittier Hospital Medical Center
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $20,415
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.45x 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 |
|---|---|---|
| Health Net Inc | $1,500 - $24,436 | 11% |
| UnitedHealthcare | $1,500 | 11% |
| Medicare (plans) | $1,560 - $21,436 | 11% |
| Health Net | $1,600 - $20,415 | 11% |
| Scan Health Plan | $1,620 | 12% |
| La Care Health Plan | $1,700 - $20,415 | 12% |
| Care 1St Health Plan | $1,750 | 12% |
| Coventry Health Care | $1,800 | 13% |
| Coventry Health Care National Network | $1,800 | 13% |
| Ahmc Reciprocity Agreement Senior/Commercial | $1,850 | 13% |
| Ahmc Medi-Cal Reciprocity Agreement | $1,937 | 14% |
| Aetna | $2,574 - $29,602 | 18% |
| Healthnet | $2,715 - $30,051 | 19% |
| Blue Cross Blue Shield | $2,890 - $20,415 | 21% |
| One Legacy | $3,000 | 21% |
| Great-West Healthcare Of California | $3,500 | 25% |
| Ahmc Health | $3,818 | 27% |
| Blue Shield Of California | $3,839 - $23,399 | 27% |
| Caremore | $5,271 | 38% |
| Cigna | $6,400 | 46% |
| Ahmc Reciprocity | $6,556 | 47% |
| Private Pay | $10,945 | 78% |
| Veterans Administration | $14,557 | 104% |
| Humana | $20,007 | 142% |
| Aids Healthcare Foundation | $20,415 | 145% |
| Allied Physicians | $20,415 | 145% |
| Alta Los Angeles Hospitals Inc | $20,415 | 145% |
| Alta Med Health Network | $20,415 | 145% |
| Apa/Aco Inc | $20,415 | 145% |
| Avanti | $20,415 - $24,956 | 145% |
| Beverly Hospital | $20,415 - $23,278 | 145% |
| Brand New Day | $20,415 - $25,519 | 145% |
| Caloptima | $20,415 | 145% |
| Central Health Plan | $20,415 | 145% |
| Easy Choice Health Plan | $20,415 | 145% |
| Emanate Health | $20,415 - $25,519 | 145% |
| Heritage Provider Network | $20,415 - $28,075 | 145% |
| Kaiser Foundation | $20,415 - $72,787 | 145% |
| Pacific Alliance Medical Center | $20,415 | 145% |
| Pacificare Of California | $20,415 | 145% |
| Prospect Health Plan | $20,415 - $33,274 | 145% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $20,796 | 148% |
| La Care Covered Direct | $20,796 | 148% |
| Self-Pay | $20,796 | 148% |
| Alignment Health Plan | $21,436 | 153% |
| Molina Healthcare Of California | $21,436 | 153% |
| San Miguel Health Plan | $22,876 | 163% |
| Chinatown Service Center Pace | $24,956 | 178% |
| Knox-Keene Act | $25,995 | 185% |
| Molina Medical Center | $25,995 | 185% |
| Fmc Los Angeles County | $32,909 | 234% |
| Interplan Health Group | $33,601 | 239% |
| Athens Administrators Ahmc Work Comp | $34,641 | 247% |
| Misc 1 | $34,641 | 247% |
| Multiplan Wc | $34,641 | 247% |