CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Franciscan Health Olympia & Chicago Heights

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $13,594
Cash Discount Price: $21,987
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Franciscan Health Olympia & Chicago Heights is $13,594. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21,987. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 0.97x the Medicare baseline. Located in 20201 S Crawford Avenue, Olympia Fields, IL.

Cash / Self-Pay

$21,987

Average discount available for prompt cash payment at this facility.

Insurance Median

$13,594

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: $21,987 (157%)

Insurance Median: $13,594 (97%)

Cash: $21,987 (157% of Medicare)

Ins. Median: $13,594 (97% 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
Blue Cross Blue Shield	$5,050 - $28,934	36%
Commercial [2001]	$12,358 - $48,222	88%
Managed Care [2000]	$12,358 - $48,222	88%
United Medical Resources [1158]	$12,358 - $13,594	88%
United Medical Resources [1301]	$12,358 - $13,594	88%
UnitedHealthcare	$12,358 - $13,594	88%
Medicare (plans)	$14,332 - $22,556	102%
Workers Comp [1172]	$33,588	239%

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 $21,987.
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 Franciscan Health Olympia & Chicago Heights 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.