Hip or knee replacement (inpatient stay)
Facility: The Orthopaedic Hospital of Lutheran Health Networ
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $21,620
- 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 |
|---|---|---|
| Amish Aid | $7,452 | 53% |
| Three Rivers Preferred | $11,139 - $14,177 | 79% |
| UnitedHealthcare | $12,897 - $22,722 | 92% |
| Lutheran Preferred | $13,888 - $21,880 | 99% |
| Aetna | $14,330 | 102% |
| Blue Cross Blue Shield | $14,330 - $27,601 | 102% |
| Humana | $14,330 | 102% |
| Iu Health Plan | $14,330 | 102% |
| Medicare (plans) | $14,330 | 102% |
| Node Mhs Mcr Adv | $14,330 | 102% |
| Small Business Aid | $14,330 | 102% |
| Node Devoted Health Mcr Adv | $14,615 | 104% |
| Node Va | $14,878 | 106% |
| In Dept Of Correction | $15,170 | 108% |
| Police And Sheriff | $15,170 | 108% |
| Node Pphp Mcr Adv | $15,316 | 109% |
| Node Us Dept Of Labor | $21,125 | 150% |
| Physicians Health Plan | $21,361 - $23,259 | 152% |
| Lutheran Advanced Network | $21,880 | 156% |
| Node Lutheran Three Rivers Preferred Plus 150 | $21,880 | 156% |
| Occunet In Work Comp | $21,880 | 156% |
| Sagamore | $24,690 - $28,934 | 176% |
| Node Lutheran Three Rivers Preferred Plus 175 | $25,526 | 182% |
| Encore Wc | $26,256 | 187% |
| Medrisk In Work Comp | $26,256 | 187% |
| Prime Health Services | $26,256 | 187% |
| Three Rivers Preferred In Work Comp | $26,256 | 187% |
| Encore Ppo | $27,601 | 197% |
| Php Freedom Network | $27,601 | 197% |
| Objective Surgical | $28,444 | 203% |
| In Work Comp | $29,173 | 208% |
| Lutheran Network | $29,173 | 208% |
| Managed Health Services | $29,173 | 208% |
| Encore Kba Epo | $35,008 | 249% |
| Encore Kba Ppo | $43,760 | 312% |