CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Harrison County Hospital

Billing Code: 470 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 470
Insurance Median: $10,703
Cash Discount Price: $32,944
vs. Medicare Baseline: 0.76x Medicare

The contracted insurance negotiated median rate for a Hip or knee replacement (inpatient stay) at Harrison County Hospital is $10,703. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32,944. Compared to the federal Medicare reimbursement reference rate of $14,044.15, this hospital’s rate is 0.76x the Medicare baseline. Located in 245 Atwood Street, Corydon, IN.

Cash / Self-Pay

$32,944

Average discount available for prompt cash payment at this facility.

Insurance Median

$10,703

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$14,044.15

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,044.15 (100%)

Cash / Self-Pay: $32,944 (235%)

Insurance Median: $10,703 (76%)

Cash: $32,944 (235% of Medicare)

Ins. Median: $10,703 (76% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$2,500 - $15,742	18%
First Health-All Plans	$2,856	20%
Humana	$4,810 - $36,678	34%
Tricare	$9,607	68%
Blue Cross Blue Shield	$10,442 - $29,781	74%
Caresource Mcaid Hip	$10,442	74%
Caresource Mcr Adv	$10,442	74%
Mdwise Mcaid Hip	$10,442	74%
Mhs Exchange-All Other Plans	$10,442	74%
Mhs Mcaid Hip	$10,442	74%
Passport Mcaid-All Other Plans	$10,442	74%
Passport Mcr Adv	$10,442	74%
UnitedHealthcare	$10,442 - $39,478	74%
Mhs Mcr Adv	$10,546	75%
Communicare Adv-All Plans	$10,651	76%
Siho Exchange	$10,755	77%
Caresource Exchange-All Other Plans	$13,575	97%
Caresource Mcaid Hhw	$15,742	112%
Mdwise Mcaid Hhw/Hcc - All Other Plans	$15,742	112%
Mhs Mcaid Hhw/Hcc	$15,742	112%
Buckeye Exchange-All Plans	$17,751	126%
Siho One Southern	$27,453	195%
Encore Encircle	$43,925	313%
Sagamore-All Plans	$43,925	313%
Siho Ppo/Hmo - All Other Plans	$43,925	313%
Beech Street Comm-All Plans	$46,671	332%
Multiplan-All Plans	$48,856	348%
Cigna	$49,416	352%
Encore Ppo - All Other Plans	$49,416	352%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $32,944.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Harrison County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 470.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.