CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Shasta Regional Medical Center

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $21,106
Cash Discount Price: $19,234
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Shasta Regional Medical Center is $21,106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,234. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.50x the Medicare baseline. Located in 1100 Butte St, Redding, CA.

Cash / Self-Pay

$19,234

Average discount available for prompt cash payment at this facility.

Insurance Median

$21,106

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: $19,234 (137%)

Insurance Median: $21,106 (150%)

Cash: $19,234 (137% of Medicare)

Ins. Median: $21,106 (150% 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
Astiva Health Inc	$18,274	130%
Health Net Of Ca	$18,274 - $41,604	130%
Managed Health Network	$18,274	130%
Renal Payer Solutions	$18,274	130%
UnitedHealthcare	$18,274	130%
Blue Shield Of Va	$19,234	137%
Medicare (plans)	$19,234	137%
Tricare	$19,234 - $26,305	137%
Imperial Health Plan	$19,370	138%
Prison	$22,842	163%
Health Net Federal Services	$24,043	171%
Employer Direct Healthcare	$25,005	178%
Worker Comp	$28,285	201%
National Healthcare Solutions, Inc (Nhsi)	$30,775	219%
Aetna	$32,991	235%
Bethel Church Of Redding	$48,086	342%

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 $19,234.
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 Shasta Regional 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.