Hip or knee replacement (inpatient stay)
Facility: Coastal Communities Hospital
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $21,527
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.53x 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 | $2,700 - $51,600 | 19% |
| Altamed Health Services | $2,800 - $3,548 | 20% |
| Heritage Provider Network | $3,199 | 23% |
| Kpc Healthcare Inc | $3,548 - $26,908 | 25% |
| Monarch | $3,648 - $21,527 | 26% |
| Cigna | $8,462 | 60% |
| Humana | $17,990 | 128% |
| Onecare | $20,450 - $21,527 | 146% |
| Blue Shield | $21,527 - $43,484 | 153% |
| Caloptima | $21,527 | 153% |
| Central Health Plan Of California | $21,527 | 153% |
| Choice Physicians Network | $21,527 | 153% |
| Citizens Choice Health Plan | $21,527 | 153% |
| Clever Care Health Plan | $21,527 | 153% |
| Easy Choice Health Plan | $21,527 | 153% |
| For Your Benefit | $21,527 | 153% |
| Healthcare Partners Sr Hmo | $21,527 | 153% |
| Heritage | $21,527 | 153% |
| Hollywood Presbyterian | $21,527 | 153% |
| Imperial Health Plan Of Ca | $21,527 | 153% |
| Innovative Integrated Health | $21,527 | 153% |
| Kaiser | $21,527 | 153% |
| Medcare Partners | $21,527 | 153% |
| Onecare Connect | $21,527 | 153% |
| Other Senior Non Contract | $21,527 | 153% |
| Prospect Health Plan | $21,527 - $32,290 | 153% |
| Scan Health Plan | $21,527 | 153% |
| Self Pay Ab774/Cbo Use Only | $21,527 | 153% |
| UnitedHealthcare | $21,527 | 153% |
| Us Dept Of Labor | $21,527 | 153% |
| Us Federal Marshall/Department Of Immigration | $21,527 | 153% |
| Velocity Provider Network Sr | $21,527 | 153% |
| Verda Health Plan Sr | $21,527 | 153% |
| Veterans Administration | $21,527 | 153% |
| Victim Of Violent Crime | $21,527 | 153% |
| Victoria Hospice | $21,527 | 153% |
| Brand New Day | $22,818 | 162% |
| Champion Health Plan | $23,249 | 166% |
| Prime Health Srvs/Wc | $23,461 | 167% |
| Prime Health Srvs | $24,756 | 176% |
| County Of Orange/Custody/Advanced Medmgt | $26,908 | 192% |
| Vitas Hospice | $27,601 | 197% |
| Coventry Auto Network | $31,051 | 221% |
| Interplan | $31,396 | 224% |
| Coventry Wc | $32,259 | 230% |
| Multiplan | $33,812 | 241% |
| Three Rivers | $33,812 | 241% |
| Velocity National Provider Network Wc | $34,502 | 246% |
| Workers Comp State Of California | $34,502 | 246% |
| Three Rivers Network | $37,672 | 268% |
| Velocity National Provider Network Ppo | $37,672 | 268% |