Hip or knee replacement (inpatient stay)
Facility: Bluffton Regional Medical Center
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $16,398
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.17x 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 |
|---|---|---|
| Lutheran Trma | $11,139 - $14,177 | 79% |
| Ahg Dana Employees | $12,924 | 92% |
| Lutheran Preferred Network | $13,502 - $23,651 | 96% |
| UnitedHealthcare | $13,938 - $15,767 | 99% |
| Amish Aid | $15,181 | 108% |
| Aetna | $15,487 | 110% |
| Blue Cross Blue Shield | $15,487 - $27,601 | 110% |
| Medicare (plans) | $15,487 | 110% |
| Node Iu Health Mcr Adv | $15,487 | 110% |
| Node Mhs Mcr Adv | $15,487 | 110% |
| Humana | $15,767 | 112% |
| Node Caresource Mcr Adv | $15,796 | 112% |
| Node Devoted Health Mcr Adv | $15,796 | 112% |
| Node Va | $16,083 | 115% |
| County Jail Health Care | $16,398 | 117% |
| In Dept Of Correction | $16,398 | 117% |
| Node Pphp Mcr Adv | $16,556 | 118% |
| Physicians Health Plan | $21,361 | 152% |
| Us Department Of Labor | $22,699 | 162% |
| Php | $23,259 | 166% |
| Lutheran Advanced Network | $23,651 | 168% |
| Lutheran Three Rivers Preferred Plus 150 | $23,651 | 168% |
| Encore Ppo | $26,203 | 187% |
| Lutheran Three Rivers Preferred Plus 175 | $27,593 | 196% |
| Php Freedom Network | $27,601 | 197% |
| Encore Work Comp In | $28,381 | 202% |
| Prime Health Services | $28,381 | 202% |
| Lutheran Northwest Health Preferred | $31,535 | 225% |
| Managed Health Services Exchange | $31,535 | 225% |
| Workers Compensation | $31,535 | 225% |
| Encore Kba Epo | $37,842 | 269% |
| Encore Kba Ppo | $47,302 | 337% |