CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Morris Hospital & Healthcare Centers

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $17,254
Cash Discount Price: $21,270
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Morris Hospital & Healthcare Centers is $17,254. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21,270. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 1.23x the Medicare baseline. Located in 150 W High St, Morris, IL.

Cash / Self-Pay

$21,270

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,254

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: $21,270 (151%)

Insurance Median: $17,254 (123%)

Cash: $21,270 (151% of Medicare)

Ins. Median: $17,254 (123% 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
Cigna	$4,680 - $17,043	33%
Choicecare Hum Othr - All Other Plans	$5,400	38%
Health Alliance - All Other Plans	$12,465	89%
Caterpillar - All Plans	$13,502	96%
Choicecare Hum Mcr Ppo	$14,934	106%
UnitedHealthcare	$14,934 - $23,162	106%
Aetna	$15,233 - $18,673	108%
Health Alliance Mcr Adv	$15,383	110%
Blue Cross Blue Shield	$17,465 - $26,108	124%
Ambetter / Centene	$24,284	173%
Multiplan - All Other Plans	$25,906	184%
Multiplan Prime Ntwrk	$25,906	184%
Hfn All Plans - All Plans	$75,142	535%
Capp Care Ppo-Oth	$81,330	579%

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 $21,270.
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 Morris Hospital & Healthcare Centers 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.