Hip or knee replacement (inpatient stay)
Facility: Dupont Hospital LLC
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $21,652
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.54x 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 Preferred | $11,139 - $32,379 | 79% |
| Amish Aid | $12,421 | 88% |
| UnitedHealthcare | $14,311 - $22,587 | 102% |
| Lutheran Network | $15,181 | 108% |
| Aetna | $15,901 | 113% |
| Blue Cross Blue Shield | $15,901 - $27,601 | 113% |
| Humana | $15,901 | 113% |
| Medicare (plans) | $15,901 | 113% |
| Node Mhs Mcr Adv | $15,901 | 113% |
| Iu Health | $16,190 | 115% |
| Node Devoted Health Mcr Adv | $16,218 | 115% |
| Node Va | $16,514 | 118% |
| In Dept Of Correction | $16,837 | 120% |
| Node Pphp Mcr Adv | $16,999 | 121% |
| Physicians Health Plan | $21,361 - $23,259 | 152% |
| Managed Health Services | $21,652 - $32,379 | 154% |
| Us Department Of Labor | $23,262 | 166% |
| Lutheran Advanced Network | $24,285 | 173% |
| Lutheran Preferred Fixed 2 | $24,285 | 173% |
| Sagamore | $24,690 - $28,934 | 176% |
| Encore Ppo | $27,601 | 197% |
| Php Freedom Network | $27,601 | 197% |
| Encore Work Comp In | $29,142 | 208% |
| Prime Health Services | $29,142 | 208% |
| In Work Comp | $32,379 | 231% |
| Encore Kba Epo | $38,855 | 277% |
| Encore Kba Ppo | $48,569 | 346% |