Hip or knee replacement (inpatient stay)
Facility: HCA Florida Northside Hospital
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $17,341
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.23x 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 |
|---|---|---|
| Molina | $1,834 - $17,506 | 13% |
| Avmed | $1,845 - $58,287 | 13% |
| Sunshine State Health Plan | $2,381 - $11,906 | 17% |
| Cigna | $3,130 - $45,470 | 22% |
| United | $4,000 - $39,611 | 28% |
| Humana | $4,363 - $45,442 | 31% |
| Simply Healthcare | $14,191 - $17,341 | 101% |
| Wellmed | $16,185 | 115% |
| Access 2 Healthcare Physicians Freedom Optimum Group Members | $16,515 | 118% |
| Sunshine State | $16,515 | 118% |
| Ultimate Health Plan | $16,515 | 118% |
| United Va Ccn | $16,515 | 118% |
| Aetna | $16,680 - $35,624 | 119% |
| Blue Cross Blue Shield | $16,680 - $43,560 | 119% |
| Access 2 Healthcare Physicians Freedom Health | $16,845 | 120% |
| Access 2 Healthcare Physicians Optimum | $16,845 | 120% |
| Devoted Health | $16,845 | 120% |
| Freedom Health Care | $16,845 | 120% |
| Optimum Healthcare | $16,845 | 120% |
| Careplus | $17,341 | 123% |
| Clear Spring Health | $17,341 | 123% |
| Suncoast Neighborly Care | $17,341 | 123% |
| American Health Plan | $17,506 | 125% |
| Align Senior Care | $17,836 | 127% |
| Baycare Health Plans | $17,836 | 127% |
| Florida Complete Care | $17,836 | 127% |
| Longevity Health Plan | $17,836 | 127% |
| Secur | $17,836 | 127% |
| Gold Kidney Of Florida | $18,001 - $18,992 | 128% |
| Centurion | $18,167 | 129% |
| Solis Health Plan | $18,167 | 129% |
| Wellcare | $18,745 | 133% |
| Oscar | $18,764 | 134% |
| Ndms Definitive Care | $20,644 | 147% |
| Evolutions Healthcare Systems | $22,086 | 157% |
| Truli | $32,421 - $41,550 | 231% |