Hip or knee replacement (inpatient stay)
Facility: Goshen Hospital
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $13,740
- Cash Discount Price: $40,345
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Advantage Health Solutions | $13,740 | 98% |
| Aetna | $13,740 | 98% |
| Atrio Health Plans | $13,740 | 98% |
| Bc Federal Employee | $13,740 | 98% |
| Bc Mcr Advantage Ppo | $13,740 | 98% |
| Blue Cross Blue Shield | $13,740 - $44,286 | 98% |
| Buckeye Health Plan | $13,740 | 98% |
| Champva | $13,740 | 98% |
| Cigna | $13,740 | 98% |
| Coventry Health And Life | $13,740 | 98% |
| Emblem Health | $13,740 | 98% |
| Freedom Healthcare | $13,740 | 98% |
| Geisinger Health Plan | $13,740 | 98% |
| Health First | $13,740 | 98% |
| Healthspring | $13,740 | 98% |
| Humana | $13,740 | 98% |
| Iehp Empire Health Plan | $13,740 | 98% |
| Independent Care Health Plan | $13,740 | 98% |
| Kaiser Permanente | $13,740 | 98% |
| Mcr Advantra Freedom | $13,740 | 98% |
| Mcr Allwell Mhs | $13,740 | 98% |
| Mcr Banner Health | $13,740 | 98% |
| Mcr Complete | $13,740 | 98% |
| Mcr Complete Ppo | $13,740 | 98% |
| Mcr Complete Wellmed | $13,740 | 98% |
| Mcr Health Alliance | $13,740 | 98% |
| Mcr Health Partners Plans | $13,740 | 98% |
| Mcr Medical Mutual Of Ohio | $13,740 | 98% |
| Mcr Passport Advantage | $13,740 | 98% |
| Mcr Secure Horizons Ppo | $13,740 | 98% |
| Mcr Texan Plus | $13,740 | 98% |
| Mcr Upmc For Life | $13,740 | 98% |
| Medicare (plans) | $13,740 - $14,152 | 98% |
| Meridian Complete | $13,740 | 98% |
| Optimum Healthcare | $13,740 | 98% |
| Paramount Elite | $13,740 | 98% |
| Primetime Health Plan | $13,740 | 98% |
| Simply Complete Hmo | $13,740 | 98% |
| The Umwa H&R Funds | $13,740 | 98% |
| Todays Options Pyramid Life | $13,740 | 98% |
| Tricare | $13,740 | 98% |
| Trillium Advantage | $13,740 | 98% |
| Ucare For Seniors | $13,740 | 98% |
| Ucare Minnesota | $13,740 | 98% |
| UnitedHealthcare | $13,740 | 98% |
| Wellcare | $13,740 | 98% |
| Mcr Devoted Health Plan | $14,152 | 101% |
| Mcr Provider Partners Hlth Pln | $15,114 | 108% |
| Ambetter / Centene | $19,236 | 137% |
| Mkt Caresource | $19,236 | 137% |
| Qca/Cha Meritain | $28,934 | 206% |
| Bc Allied | $44,286 | 315% |