CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Centinela Hospital Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $26,798
Cash Discount Price: $20,085
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Centinela Hospital Medical Center is $26,798. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20,085. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.91x the Medicare baseline. Located in 555 East Hardy Street, Inglewood, CA.

Cash / Self-Pay

$20,085

Average discount available for prompt cash payment at this facility.

Insurance Median

$26,798

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%)

Cash / Self-Pay: $20,085 (143%)

Insurance Median: $26,798 (191%)

Cash: $20,085 (143% of Medicare)

Ins. Median: $26,798 (191% 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
Keenan	$7,650	54%
Avanti Hospitals, Llc	$19,057	136%
Blue Shield Of Ca Triwest Healthcare Ccn	$19,057	136%
Health Net Of Ca	$19,057 - $36,394	136%
L.A Care Health Plan	$19,057 - $20,085	136%
Molina	$19,057 - $20,085	136%
Renal Payer Solutions	$19,057	136%
Welbe Health Pace	$19,057	136%
Brand New Day	$19,247	137%
Aids Healthcare Foundation	$19,438	138%
Medicare (plans)	$20,085	143%
Imperial Health Plan	$20,200	144%
Employer Direct Healthcare	$26,111	186%
Tricare	$27,486	196%
Naphcare	$31,132	222%
Corvel	$31,637	225%
National Healthcare Solutions	$32,136	229%
Aetna	$32,303	230%
Americas Choice Provider Network	$32,303	230%
Multiplan	$32,303	230%
Occunet	$32,303	230%
Prime Health Services	$32,303	230%
Three Rivers Provider Network	$32,303	230%
Healthsmart Preferred Network	$32,636	232%
Provider Select	$32,969	235%
Provider Network Of America	$33,302	237%
Worker Compensation	$33,302	237%

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 $20,085.
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 Centinela Hospital 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.