CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Franciscan Health Michigan City

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$22,842

about 1.6× the $14,044 Medicare rate · typically $15,520–$40,901

modeled estimate · not a bill or quote

What this hospital charges insurers

$32,411

Above the fair price

about $9,569 over the fair price · 2.3× Medicare

Medicare pays $14,044 Fair price $22,842 This hospital $32,411 Cash price $19,312 Hospital's list price $92,847

How we calculate the fair BaseRate →

How this hospital compares to other IN hospitals

Highest price of the 9 IN hospitals we have prices for — worth calling around.

Cheapest $10,414 Priciest $32,411

Black dot = this hospital, among the 9 IN hospitals with a price for this procedure. Full list below.

A fair price for a Hip or knee replacement (inpatient stay) is about $22,842 (about 1.6× the $14,044 Medicare rate). Franciscan Health Michigan City charges insurers about $32,411, or about $19,312 in cash — above the fair price. Located in Michigan City, IN.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $22,842. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$12,388 - $13,626	88%
Blue Cross Blue Shieldmajor	$28,934 - $32,411	206%
Aetnamajor	$48,222	343%
UniCare	$32,411	231%
+ 2 smaller / regional plans	$12,388 - $48,222

Government programs also on file: Medicare.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 19,312), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 470.

Insurance Before you use insurance

Call your insurance company to confirm Franciscan Health Michigan City is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 470.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Franciscan Health Michigan City

Compare: Hip or knee replacement (inpatient stay) at other IN hospitals

Putnam County Hospital · Greencastle $10,414
Norton Scott Hospital · Scottsburg $12,000
Pinnacle Hospital · Crown Point $12,487
Schneck Medical Center · Seymour $12,648
Ascension St Vincent Warrick · Boonville $13,590
Ascension St Vincent Salem · Salem $13,700
Goshen Hospital · Goshen $13,740
Ascension St Vincent Evansville · Evansville $13,833

Insurance negotiated median for the same procedure, sorted lowest first.