Hip or knee replacement (inpatient stay)
Facility: Garfield Medical Center
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $20,010
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.42x 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 |
|---|---|---|
| Pipa Risk Pool Agreement | $1,480 | 11% |
| UnitedHealthcare | $1,500 - $20,212 | 11% |
| Physician Healthways Medical Corporation | $1,558 | 11% |
| Health Net | $1,600 - $30,946 | 11% |
| Scan Health Plan Sr Hmo | $1,620 | 12% |
| La Care Health Plan | $1,700 - $20,212 | 12% |
| Care 1St Health Plan | $1,750 | 12% |
| Ahmc Healthcare Inc | $1,850 - $6,556 | 13% |
| Private Pay | $2,000 | 14% |
| Allied Physicians Risk Pool Agreement | $2,450 - $4,600 | 17% |
| Aetna | $2,574 - $20,212 | 18% |
| One Legacy | $3,000 | 21% |
| Blue Shield Of California | $3,885 - $20,589 | 28% |
| Blue Cross Blue Shield | $3,909 - $20,589 | 28% |
| Blue Shield | $4,332 - $20,212 | 31% |
| Ahmc Health Epo | $4,797 | 34% |
| Cigna | $7,729 | 55% |
| Veterans Administration | $14,412 | 103% |
| Humana | $19,808 | 141% |
| Aids Health Foundation | $20,212 | 144% |
| Apa Aco Inc | $20,212 | 144% |
| Avanti | $20,212 - $24,707 | 144% |
| Beverly Hospital | $20,212 - $22,648 | 144% |
| Central Health Plan | $20,212 | 144% |
| Cms | $20,212 | 144% |
| Easy Choice Health Plan | $20,212 | 144% |
| Non-Contract Medi-Care | $20,212 | 144% |
| Pacific Alliance Medical Center Comm/Sr | $20,212 | 144% |
| Brand New Day | $20,589 - $25,737 | 147% |
| Emanate Health | $20,589 - $25,737 | 147% |
| First Health Network | $20,589 | 147% |
| La Care Covered Direct | $20,589 | 147% |
| Self-Pay | $20,589 | 147% |
| Ucla Impact Dept Of Uncology | $20,589 | 147% |
| Fmc Los Angeles Co Epo | $20,701 | 147% |
| Interplan | $20,701 - $35,660 | 147% |
| Alignment Health Plan | $21,223 | 151% |
| Molina Healthcare | $21,223 | 151% |
| Molina Healthcare Of California | $21,223 - $25,737 | 151% |
| Cv-19 Hrsa Uninsured Testing And Tx | $21,369 | 152% |
| Inter Valley Health Plan | $21,619 | 154% |
| National Disaster Medical System | $22,648 | 161% |
| San Miguel Health Plan | $22,648 | 161% |
| Health Net Comm/Hmo | $23,492 - $36,916 | 167% |
| Health Net Inc | $23,492 | 167% |
| Chinatown Service Center Pace | $24,707 | 176% |
| Knox-Keene Act | $25,737 | 183% |
| Preferred Health Network | $34,925 | 249% |
| Athens Administrators | $36,763 | 262% |
| Multiplan | $36,763 | 262% |
| Other Non-Contracted Workers Compensation | $36,763 | 262% |