Hip or knee replacement (inpatient stay)
Facility: Greater El Monte Community Hospital
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $20,774
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.48x 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 Foundation | $1,500 - $24,146 | 11% |
| La Care Health Plan | $1,700 - $20,774 | 12% |
| Care 1St Health Plan | $1,750 | 12% |
| Ahmc Reciprocity Agreement Senior/Commercial | $1,850 | 13% |
| Ahmc Healthcare Inc | $1,937 | 14% |
| Health Net Inc | $2,714 - $29,818 | 19% |
| One Legacy | $3,000 | 21% |
| Pacificare Of California | $3,222 - $21,162 | 23% |
| Blue Cross Blue Shield | $3,540 - $20,774 | 25% |
| Ahmc Health Self-Insurance Epo | $3,618 | 26% |
| Blue Shield Of California | $4,149 - $28,797 | 30% |
| Ahmc Reciprocity Agreement | $6,556 | 47% |
| Cigna | $6,750 | 48% |
| Veterans Administration | $14,814 | 105% |
| Beverly Hospital | $20,415 - $23,278 | 145% |
| Aids Health Foundation | $20,774 | 148% |
| Altamed Health Network | $20,774 | 148% |
| Apa/Aco Inc | $20,774 | 148% |
| Avanti | $20,774 - $25,395 | 148% |
| Brand New Day | $20,774 - $26,453 | 148% |
| Cms | $20,774 | 148% |
| Easy Choice Health Plan | $20,774 | 148% |
| Other Non Contracted Senior Hmo | $20,774 | 148% |
| Pacific Alliance Medical Center Reciprocal Contract | $20,774 | 148% |
| Scan Health Plan | $20,774 | 148% |
| UnitedHealthcare | $20,774 | 148% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $21,162 | 151% |
| Emanate Health | $21,162 - $26,453 | 151% |
| La Care Covered Direct | $21,162 | 151% |
| Self-Pay | $21,162 | 151% |
| Alignment Health Plan | $21,812 | 155% |
| Molina Healthcare | $21,812 | 155% |
| Inter Valley Health Plan | $22,220 | 158% |
| Molina Healthcare Of California | $22,220 - $26,453 | 158% |
| San Miguel Health Plan | $23,278 | 166% |
| Chinatown Service Center Pace | $24,928 | 177% |
| Knox-Keene Act | $26,453 | 188% |
| Preferred Health Network | $35,062 | 250% |
| Interplan | $35,800 | 255% |
| Athens Administrators | $36,907 | 263% |
| Multiplan | $36,907 | 263% |
| Other Non Contracted Work Comp | $36,907 | 263% |