CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: HCA Healthone Rose

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $15,978
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at HCA Healthone Rose is $15,978. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.14x the Medicare baseline. Located in 4567 E 9Th Ave, Denver, CO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$15,978

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%)

Insurance Median: $15,978 (114%)

Ins. Median: $15,978 (114% 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
Physician Health Partners	$1,680 - $1,975	12%
Blue Cross Blue Shield	$2,841 - $52,033	20%
Cigna	$3,334 - $40,198	24%
United	$3,739 - $33,586	27%
Kaiser	$3,940 - $35,791	28%
Rocky Mountain Health Plan	$5,097 - $33,586	36%
Aetna	$5,738 - $18,209	41%
Bright Health	$15,978	114%
Humana	$15,978	114%
Rocky Mountain Health	$15,978	114%
Total Longterm Care	$15,978	114%
Triwest Health Alliance	$15,978	114%
Devoted Health	$16,298	116%
Innovage Pace	$16,298	116%
Wellcare	$16,458	117%
Mutual Of Omaha	$16,777	119%
Delaware Life Insurance	$17,097	122%
Pinnacol Workers Comp	$21,712	155%
Multiplan	$22,626	161%

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 $X.
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 HCA Healthone Rose 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.